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  5. LAKE CITY MGT, LLC

LAKE CITY MGT, LLC - Florida Company Profile

Company Details

Entity Name: LAKE CITY MGT, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

LAKE CITY MGT, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 24 Mar 2003 (22 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 29 Jan 2016 (9 years ago)
Document Number: L03000010664
FEI/EIN Number 050560677

Federal Employer Identification (FEI) Number assigned by the IRS.
Mail Address: PO Box 530787, DEBARY, FL, 32753, US
Address: 1207 S.W. Main Street, Suite 1-E, Lake City, FL, 32025, US
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750365706 2005-12-02 2020-10-08 1270 SW MAIN BLVD, LAKE CITY, FL, 320256684, US 1270 SW MAIN BLVD, LAKE CITY, FL, 320256684, US

Contacts
Phone +1 386-752-7900
Fax 3867528556

Authorized person
Name MR. LAVERN PATRICK HERZOG
Role PRESIDENT
Phone 3869566956

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF15510961
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 026162900
State FL

Key Officers & Management

Name Role Address
HERZOG L P Manager PO Box 530787, DEBARY, FL, 32753
SWAIN W S Manager PO Box 71030, Myrtle Beach, SC, 29572
COGENCY GLOBAL INC. Agent -

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G09000104074 AVALON HEALTHCARE CENTER EXPIRED 2009-05-05 2024-12-31 - 1270 SW MAIN BOULEVARD, LAKE CITY, FL, 32055

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-04-19 1207 S.W. Main Street, Suite 1-E, Lake City, FL 32025 -
REGISTERED AGENT ADDRESS CHANGED 2017-04-24 115 North Calhoun Street, Suite 4, Tallahassee, FL 32301 -
CHANGE OF PRINCIPAL ADDRESS 2016-04-29 1207 S.W. Main Street, Suite 1-E, Lake City, FL 32025 -
LC STMNT OF RA/RO CHG 2016-01-29 - -
REGISTERED AGENT NAME CHANGED 2016-01-29 COGENCY GLOBAL INC. -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J21000566269 ACTIVE 18001114CCAXMX COLUMBIA COUNTY COURT CLERK 2021-07-16 2026-11-10 $8,465.26 EMORY MEDICAL CORPORATION DBA WOMEN'S CENTER OF FLORIDA, 4812 W. US HWY 90 SUITE A, LAKE CITY FL, 32055

Documents

Name Date
ANNUAL REPORT 2024-04-19
ANNUAL REPORT 2023-04-11
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-04-22
ANNUAL REPORT 2020-04-09
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-04-18
ANNUAL REPORT 2017-04-24
ANNUAL REPORT 2016-04-29
CORLCRACHG 2016-01-29

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7390147008 2020-04-07 0491 PPP 1270 SW Main Blvd, LAKE CITY, FL, 32025-6684
Loan Status Date 2021-07-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 926421.92
Loan Approval Amount (current) 926421.92
Undisbursed Amount 0
Franchise Name -
Lender Location ID 57912
Servicing Lender Name The Park National Bank
Servicing Lender Address 50 N Third St, NEWARK, OH, 43055-5523
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address LAKE CITY, COLUMBIA, FL, 32025-6684
Project Congressional District FL-03
Number of Employees 105
NAICS code 623110
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 57912
Originating Lender Name The Park National Bank
Originating Lender Address NEWARK, OH
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 936904.45
Forgiveness Paid Date 2021-06-11

Companies related by officers

HERZOG L P

HCPIII WEST PALM BEACH, INC. - Inactive
Foreign Profit (1996 - 1998)
PORT ST. LUCIE MGT, LLC - Active
Florida Limited Liability Co. (2003 )
BRANDYWINE CONVALESCENT CENTER, INC. - Active
Domestic Profit (2000 )
VSJG HEALTHCARE I, INC. - Inactive
Domestic Profit (2001 - 2021)
VSJG HEALTHCARE I, INC. - Inactive
Domestic Profit (2001 - 2021)
THE PALMS MGT, LLC - Active
Florida Limited Liability Co. (2004 - 2025)
WALTON ROAD MGT LLC - Active
Florida Limited Liability Co. (2012 )
MANATEE MEDICAL PRODUCTS AND SERVICES, INC. - Inactive
Foreign Profit (1995 - 1999)
JUPITER MGT, LLC - Inactive
Florida Limited Liability Co. (2003 - 2023)

SWAIN W S

HCPIII WEST PALM BEACH, INC. - Inactive
Foreign Profit (1996 - 1998)
HCPIII WEST PALM BEACH, INC. - Inactive
Foreign Profit (1996 - 1998)
PORT ST. LUCIE MGT, LLC - Active
Florida Limited Liability Co. (2003 )
ATLANTIC HOUSE OF POMPANO BEACH, INC. - Inactive
Domestic Profit (1999 - 2001)
ATLANTIC HEALTHCARE CONSULTING, INC. - Inactive
Domestic Profit (1999 - 2015)

COGENCY GLOBAL INC.

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Foreign Limited Liability Co. (2017 )
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Florida Limited Liability Co. (2021 )
CONTINUUMHR OF FLORIDA, LLC - Active
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AVANTI MORTGAGE, LLC - Active
Foreign Limited Liability Co. (2023 )
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Foreign Profit (2020 )
GALILEO SOLUTIONS, LTD, CORPORATION - Inactive
Foreign Profit (2010 - 2013)
ECF, INC. - Active
Foreign Profit (2018 )
ACQUIRED ASSETS, LTD. INCORPORATED - Active
Foreign Profit (1999 )
SCANNELL PROPERTIES #518, LLC - Active
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Companies related by address

PO Box 530787, DEBARY, FL, 32753, US

LAKE MIRIAM MGT LLC CANOE CREEK MGT LLC MAIN BOULEVARD MGT LLC KINGSLEY AVENUE MGT, LLC THE PALMS MGT, LLC BRANDYWINE CONVALESCENT CENTER, INC. KISSIMMEE PROPERTIES I, LLC PORT ST. LUCIE MGT, LLC

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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