| Entity Name: | SUMMERVILLE AT LAKELAND, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 21 Jun 2005 (20 years ago) |
| Date of dissolution: | 22 Oct 2017 (7 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 22 Oct 2017 (7 years ago) |
| Document Number: | M05000003564 |
| FEI/EIN Number | 20-3013628 |
| Address: | 111 Westwood Place, Suite 400, Brentwood, TN 37027 |
| Mail Address: | 111 Westwood Place, Suite 400, Brentwood, TN 37027 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518176346 | 2007-05-21 | 2015-03-13 | 6737 W WASHINGTON ST, SUITE 2300, ATTN: AR MEDICAID, MILWAUKEE, WI, 53214, US | 2111 LAKELAND HILLS BLVD., BROOKDALE LAKELAND HILLS, LAKELAND, FL, 33803, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 206-298-2909 |
| Fax | 2063014500 |
| Phone | +1 863-688-1126 |
| Fax | 8636836800 |
Authorized person
| Name | MARK OHLENDORF |
| Role | PRESIDENT/CEO |
| Phone | 4149185403 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL6107 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 311500000X - Alzheimer Center (Dementia Center) |
| License Number | AL6107 |
| State | FL |
| Is Primary | No |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Smith, T. Andrew | Chief Executive Officer | 111 Westwood Place, Suite 400 Brentwood, TN 37027 |
| Name | Role | Address |
|---|---|---|
| Smith, T. Andrew | Interim CFO | 111 Westwood Place, Suite 400 Brentwood, TN 37027 |
| Name | Role | Address |
|---|---|---|
| Smith, T. Andrew | President | 111 Westwood Place, Suite 400 Brentwood, TN 37027 |
| Name | Role |
|---|---|
| SUMMERVILLE SENIOR LIVING, INC. | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000012750 | BROOKDALE LAKELAND HILLS | EXPIRED | 2015-02-04 | 2020-12-31 | No data | 111 WESTWOOD PL STE 400, BRENTWOOD, TN, 37027 |
| G09054900672 | EMERITUS AT LAKELAND | EXPIRED | 2009-02-23 | 2014-12-31 | No data | 3131 ELLIOTT AVE., SUITE 500, SEATTLE, WA, 98121 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2017-10-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-29 | 111 Westwood Place, Suite 400, Brentwood, TN 37027 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-13 | 111 Westwood Place, Suite 400, Brentwood, TN 37027 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-09-07 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-09-07 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-04-13 |
| ANNUAL REPORT | 2014-04-27 |
| ANNUAL REPORT | 2013-04-23 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-04-15 |
| ANNUAL REPORT | 2010-04-23 |
| ANNUAL REPORT | 2009-04-29 |
| ANNUAL REPORT | 2008-04-23 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
