| Entity Name: | BLC WELLINGTON-FORT WALTON BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jan 2006 (19 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 04 Oct 2016 (8 years ago) |
| Document Number: | M06000000543 |
| FEI/EIN Number | 204228243 |
| Address: | 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN, 37027, US |
| Mail Address: | 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN, 37027, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114616612 | 2023-05-02 | 2023-05-02 | 6737 W WASHINGTON ST STE 2300, MILWAUKEE, WI, 532145650, US | 233 CARMEL DR, FORT WALTON BEACH, FL, 325471957, US | |||||||||||||||
|
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| Phone | +1 414-918-5000 |
| Phone | +1 850-864-4600 |
Authorized person
| Name | JOANNE LESKOWICZ |
| Role | SENIOR VICE PRESIDENT |
| Phone | 4149185000 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| FISCHER LAURA E | Manager | 111 WESTWOOD PLACE, BRENTWOOD, TN, 37027 |
| Baier Lucinda M | Manager | 111 WESTWOOD PLACE, BRENTWOOD, TN, 37027 |
| White Chad C | Manager | 111 WESTWOOD PLACE, BRENTWOOD, TN, 37027 |
| RICCI BENJAMIN E | Manager | 111 WESTWOOD PLACE, BRENTWOOD, TN, 37027 |
| Name | Role | Address |
|---|---|---|
| KUSSOW DAWN L | Chief Financial Officer | 111 WESTWOOD PLACE, BRENTWOOD, TN, 37027 |
| Name | Role | Address |
|---|---|---|
| Kussow Dawn L | Executive Vice President | 111 WESTWOOD PLACE, BRENTWOOD, TN, 37027 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000022921 | BROOKDALE FORT WALTON BEACH | ACTIVE | 2015-03-03 | 2025-12-31 | No data | 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN, 37027 |
| G14000030533 | WELLINGTON PLACE OF FORT WALTON BEACH | EXPIRED | 2014-03-26 | 2019-12-31 | No data | 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN, 37027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2016-10-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-10-04 | 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN 37027 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-04 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-04 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-25 | 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN 37027 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-27 |
| ANNUAL REPORT | 2023-04-22 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-04-28 |
| CORLCRACHG | 2016-10-04 |
| ANNUAL REPORT | 2016-03-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
