| Entity Name: | EASTLAKE REHAB & CARE CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Sep 2004 (20 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 27 Jan 2014 (11 years ago) |
| Document Number: | L04000069159 |
| FEI/EIN Number | 201652090 |
| Mail Address: | 24641 US HWY 19 NORTH, CLEARWATER, FL, 33763, US |
| Address: | 2144 Welbilt Rd., New Port Richey, FL, 34655, US |
| ZIP code: | 34655 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144404716 | 2007-12-19 | 2010-10-28 | 2144 WELBILT BLVD, TRINITY, FL, 346555186, US | 2144 WELBILT BLVD, TRINITY, FL, 346555186, US | |||||||||||||||||||||||||
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| Phone | +1 727-859-4100 |
| Fax | 7278594150 |
Authorized person
| Name | MR. BEN ATKINS |
| Role | CEO |
| Phone | 7272249874 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF130471040 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003521 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 S PINE ISLAND RD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| ARK MGMT HOLDINGS, LLC | Manager | 24641 US HWY 19 NORTH, CLEARWATER, FL, 33763 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000101354 | TRINITY REGIONAL REHAB CENTER | ACTIVE | 2024-08-26 | 2029-12-31 | No data | 24641 US HWY 19 N., CLEARWATER, FL, 33763 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-04-30 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-30 | 1200 S PINE ISLAND RD, 250, PLANTATION, FL 33324 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-16 | 2144 Welbilt Rd., New Port Richey, FL 34655 | No data |
| LC AMENDMENT | 2014-01-27 | No data | No data |
| LC AMENDMENT | 2013-06-11 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-08-26 | 2144 Welbilt Rd., New Port Richey, FL 34655 | No data |
| CANCEL ADM DISS/REV | 2007-10-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-03-16 |
| ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2018-03-18 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-01-20 |
| ANNUAL REPORT | 2015-03-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
