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LAKE WALES HEALTHCARE, LLC - Florida Company Profile

Company Details

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.
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: 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

National Provider Identifier

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

Contacts

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

Key Officers & Management

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 -

Fictitious Names

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

Events

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 -

Documents

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