| Entity Name: | LAKE HOUSE ASSISTED LIVING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Dec 2014 (10 years ago) |
| Document Number: | L15000000005 |
| FEI/EIN Number | 47-2686798 |
| Address: | 1071 LAKE AVE NE, LARGO, FL, 33771 |
| Mail Address: | 1071 LAKE AVE NE, LARGO, FL, 33771 |
| ZIP code: | 33771 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831545789 | 2016-05-10 | 2016-05-10 | 1071 LAKE AVE NE, LARGO, FL, 337711669, US | 1071 LAKE AVE NE, LARGO, FL, 337711669, US | |||||||||||||||||||||||||
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| Phone | +1 727-581-9111 |
| Fax | 7277819222 |
Authorized person
| Name | ERIC MOORE |
| Role | VP OPERATIONS |
| Phone | 7275819111 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL12827 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA AGENCY OF HEALTHCARE ADMINISTRATION |
| Number | AL12827 |
| State | FL |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 549300DF1UKT5F36T657 | L15000000005 | US-FL | GENERAL | ACTIVE | No data | |||||||||||||||||||
|
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| Legal | C/O Moore, Eric S, 1071 Lake Avenue North East, Largo, US-FL, US, 33771 |
| Headquarters | 1071 Lake Avenue North East, Largo, US-FL, US, 33771 |
Registration details
| Registration Date | 2018-09-27 |
| Last Update | 2023-08-04 |
| Status | LAPSED |
| Next Renewal | 2019-09-26 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | L15000000005 |
| Name | Role | Address |
|---|---|---|
| Moore Eric S | Agent | 1071 LAKE AVE NE, LARGO, FL, 33771 |
| Name | Role |
|---|---|
| ROSEWOOD HOUSE II, INC. | Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000020494 | LAKE HOUSE ASSITED LIVING | ACTIVE | 2024-02-06 | 2029-12-31 | No data | 1071 LAKE AVE NE, LARGO, FL, 33771 |
| G16000034253 | LAKE HOUSE ASSISTED LIVING | EXPIRED | 2016-04-04 | 2021-12-31 | No data | 1071 LAKE AVE NE, LARGO, FL, 33771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-03-24 | Moore, Eric S | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-07-19 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-03-31 |
| ANNUAL REPORT | 2017-03-24 |
| ANNUAL REPORT | 2016-04-30 |
| Florida Limited Liability | 2014-12-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
