| Entity Name: | SUMMERVILLE AT CLEARWATER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 21 Jun 2005 (20 years ago) |
| Date of dissolution: | 29 Sep 2023 (2 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 29 Sep 2023 (2 years ago) |
| Document Number: | M05000003541 |
| FEI/EIN Number |
203014318
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 111 Westwood Place, Brentwood, TN, 37027, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275744138 | 2007-05-24 | 2016-06-13 | 6737 W WASHINGTON ST STE 2300, MILWAUKEE, WI, 532145650, US | 2750 DREW STREET, CLEARWATER, FL, 33759, US | |||||||||||||||||||||||||||||
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| Phone | +1 414-918-5000 |
| Fax | 9258668468 |
| Phone | +1 727-799-2177 |
| Fax | 7277264145 |
Authorized person
| Name | BRYAN RICHARDSON |
| Role | EVP, CHIEF ADMIN. OFFICER |
| Phone | 6155648131 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL6670 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0110369-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Baier Lucinda M | Chief Executive Officer | 111 Westwood Place, Brentwood, TN, 37027 |
| FISCHER LAURA E | Director | 111 Westwood Place, Brentwood, TN, 37027 |
| FISCHER LAURA E | Vice President | 111 Westwood Place, Brentwood, TN, 37027 |
| White Chad C | Executive Vice President | 111 Westwood Place, Brentwood, TN, 37027 |
| KUSSOW DAWN L | Chief Financial Officer | 6737 W WASHINGTON ST STE 2300, MILWAUKEE, WI, 53214 |
| Leskowicz Joanne | Secretary | 6737 W Washington Street, MILWAUKEE, WI, 53214 |
| Leskowicz Joanne | Vice President | 6737 W Washington Street, MILWAUKEE, WI, 53214 |
| SUMMERVILLE SENIOR LIVING, INC. | Managing Member | - |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000117988 | BROOKDALE CLEARWATER | EXPIRED | 2014-11-24 | 2019-12-31 | - | 3131 ELLIOTT AVE STE 500, SEATTLE, WA, 98121 |
| G09054900655 | EMERITUS AT CLEARWATER | EXPIRED | 2009-02-23 | 2014-12-31 | - | 3131 ELLIOTT AVE., SUITE 500, SEATTLE, WA, 98121 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2023-09-29 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-29 | 111 Westwood Place, Suite 400, Brentwood, TN 37027 | - |
| REGISTERED AGENT NAME CHANGED | 2007-09-07 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2007-09-07 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| Name | Date |
|---|---|
| WITHDRAWAL | 2023-09-29 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-04-13 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
