| Entity Name: | MF LAKE EUSTIS, 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: | 09 Jun 2008 (17 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | M08000002728 |
| FEI/EIN Number |
262694775
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 9511 Holsberry Lane, PENSACOLA, FL, 32534, US |
| Address: | 411 W. WOODWARD AVENUE, EUSTIS, FL, 32726, US |
| ZIP code: | 32726 |
| County: | Lake |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629238159 | 2008-06-09 | 2015-10-05 | 40 SOUTH PALAFOX PLACE, SUITE 400, PENSACOLA, FL, 325025697, US | 411 W WOODWARD AVE, EUSTIS, FL, 327264554, US | |||||||||||||
|
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| Phone | +1 352-357-3565 |
Authorized person
| Name | JAMES RICHARDSON |
| Role | PRESIDENT |
| Phone | 8504300000 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | - |
| FLORIDA FACILITIES, LLC | Managing Member | - |
| WOLF SHERYL | Treasurer | 9511 Holsberry Lane, PENSACOLA, FL, 32534 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000053853 | LAKE EUSTIS HEALTH AND REHABILITATION CENTER | EXPIRED | 2014-06-04 | 2019-12-31 | - | 411 W. WOODWARD AVENUE, EUSTIS, FL, 32726 |
| G08337900069 | LAKE EUSTIS CARE CENTER | EXPIRED | 2008-12-02 | 2013-12-31 | - | 411 W. WOODWARD AVENUE, EUSTIS, FL, 32726 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2023-09-22 | - | - |
| CHANGE OF MAILING ADDRESS | 2022-04-05 | 411 W. WOODWARD AVENUE, EUSTIS, FL 32726 | - |
| LC AMENDMENT | 2015-10-09 | - | - |
| REGISTERED AGENT NAME CHANGED | 2013-07-22 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2013-07-22 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-23 | 411 W. WOODWARD AVENUE, EUSTIS, FL 32726 | - |
| LC AMENDMENT | 2008-08-08 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-04-09 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-29 |
| Reg. Agent Change | 2013-07-22 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 345494454 | 0420600 | 2021-08-24 | 411 W WOODWARD AVE, EUSTIS, FL, 32726 | |||||||||||||||||||||||||||||||||||||||||||
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| Type | Inspection |
| Activity Nr | 1549287 |
| Health | Yes |
| Inspection Type | Referral |
| Scope | Partial |
| Safety/Health | Safety |
| Close Conference | 2016-08-03 |
| Case Closed | 2016-08-31 |
Related Activity
| Type | Referral |
| Activity Nr | 1119363 |
| Safety | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Other |
| Standard Cited | 19040039 A02 |
| Issuance Date | 2016-08-15 |
| Current Penalty | 540.0 |
| Initial Penalty | 900.0 |
| Final Order | 2016-08-31 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1904.39(a)(2): The employer did not report the in-patient hospitalization, amputation, or loss of an eye as a result of a work-related incident to OSHA within twenty-four (24) hours. a. At the job site - On August 01, 2016 the employer called OSHA to report an accident that occurred on July 26, 2016 where an employee was hospitalized due to a fracture caused by a fall. |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
