| Entity Name: | LAKE WALES HEALTHCARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
LAKE WALES HEALTHCARE, 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. |
| 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: | 28 Dec 2010 (14 years ago) |
| Document Number: | L10000131664 |
| FEI/EIN Number |
NOT APPLICABLE
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 801 BROAD STREET, SUITE 300, CHATTANOOGA, TN, 37402, US |
| Address: | 730 NORTH SCENIC HIGHWAY, LAKE WALES, FL, 33853 |
| ZIP code: | 33853 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700182235 | 2011-02-01 | 2011-02-01 | 730 N SCENIC HWY, LAKE WALES, FL, 338533208, US | 730 N SCENIC HWY, LAKE WALES, FL, 338533208, US | |||||||||||||||||||||||
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| Phone | +1 863-676-1512 |
Authorized person
| Name | MRS. ALICE MARIE CLARK DANKS |
| Role | VP OF FINANCE |
| Phone | 4233081845 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF12760961 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031934100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TAYLOR CRAIG | Managing Member | 801 BROAD STREET, SUITE 300, CHATTANOOGA, TN, 37402 |
| SOUCHET EMBER | Secretary | 801 BROAD STREET, SUITE 300, CHATTANOOGA, TN, 37402 |
| NRAI SERVICES, INC. | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000012745 | GRACE HEALTHCARE OF LAKE WALES | EXPIRED | 2011-02-02 | 2016-12-31 | - | 730 N. SCENIC HIGHWAY, LAKE WALES, FL, 33853 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 730 NORTH SCENIC HIGHWAY, LAKE WALES, FL 33853 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2011-02-11 | 1200 South Pine Island Road, Plantation, FL 33324 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-06-23 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-02-09 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
