| Entity Name: | LITHIA ASSISTED LIVING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 May 2015 (10 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Oct 2020 (4 years ago) |
| Document Number: | L15000093730 |
| FEI/EIN Number | 47-4142063 |
| Address: | 13470 Boyette Rd, Riverview, FL, 33569, US |
| Mail Address: | 13470 Boyette Rd, Riverview, FL, 33569, US |
| ZIP code: | 33569 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376023945 | 2018-08-14 | 2018-08-14 | 13470 BOYETTE RD, RIVERVIEW, FL, 335695706, US | 13470 BOYETTE RD, RIVERVIEW, FL, 33569, US | |||||||||||||||||||
|
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| Phone | +1 813-278-5800 |
| Fax | 8132785906 |
Authorized person
| Name | MRS. AMY VAN KLEECK |
| Role | EXECUTIVE DIRECTOR |
| Phone | 8132785800 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 13122 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DENTINGER THOMAS A | Agent | 3418 BEECH TRAIL, CLEARWATER, FL, 33761 |
| Name | Role |
|---|---|
| RIVER SPRINGS AL-MC II, LLC | Manager |
| Name | Role | Address |
|---|---|---|
| BOYETTE MEMBERS, LLC | Authorized Member | C/O 41 MADISON AVENUE, 35TH FLOOR, NEW YORK, NY, 10010 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000051235 | TWIN CREEKS ASSISTED LIVING AND MEMORY CARE | ACTIVE | 2016-05-23 | 2026-12-31 | No data | 3418 BEECH TRAIL, CLEARWATER, FL, 33761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2020-10-05 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-21 | 13470 Boyette Rd, Riverview, FL 33569 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-21 | 13470 Boyette Rd, Riverview, FL 33569 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-02-15 |
| LC Amendment | 2020-10-05 |
| ANNUAL REPORT | 2020-02-22 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-29 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-04-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
