Entity Name: | SH LAKE HOWARD, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Co. |
Status: | Inactive |
Date Filed: | 01 Feb 2019 (6 years ago) |
Date of dissolution: | 23 Sep 2022 (2 years ago) |
Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
Event Date Filed: | 23 Sep 2022 (2 years ago) |
Document Number: | L19000033244 |
FEI/EIN Number | 61-1921743 |
Address: | 2573 BARRINGTON CIRCLE, TALLAHASSEE, FL, 32308, US |
Mail Address: | 2573 BARRINGTON CIRCLE, TALLAHASSEE, FL, 32308, US |
ZIP code: | 32308 |
County: | Leon |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1215591144 | 2019-04-25 | 2020-02-26 | 2573 BARRINGTON CIR, TALLAHASSEE, FL, 323086805, US | 650 N LAKE HOWARD DR, WINTER HAVEN, FL, 338813162, US | |||||||||||||||||||
|
Phone | +1 863-293-3171 |
Authorized person
Name | SETH WALKER |
Role | CFO, SRI MANAGEMENT, LLC |
Phone | 8505837990 |
Taxonomy
Taxonomy Code | 310400000X - Assisted Living Facility |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 103042200 |
State | FL |
Name | Role | Address |
---|---|---|
HANEY MARK T | Agent | 1656 METROPOLITAN CIRCLE, TALLAHASSEE, FL, 32308 |
Name | Role |
---|---|
SH SENIOR HOLDINGS, LLC | Manager |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G19000034920 | LAKE HOWARD HEIGHTS | EXPIRED | 2019-03-15 | 2024-12-31 | No data | 2573 BARRINGTON CIRCLE, TALLAHASSEE, FL, 32308 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2021-01-22 |
ANNUAL REPORT | 2020-02-06 |
Florida Limited Liability | 2019-02-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State