| Entity Name: | LAKE PARK OF MADISON, 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: | 15 Dec 2008 (16 years ago) |
| Date of dissolution: | 09 Nov 2009 (15 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 09 Nov 2009 (15 years ago) |
| Document Number: | M08000005400 |
| Address: | 1978 8TH AVE. NW, HICKORY, NC, 28601 |
| Mail Address: | 1978 8TH AVE. NW, HICKORY, NC, 28601 |
| Place of Formation: | VIRGINIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184876914 | 2008-10-10 | 2008-10-10 | PO BOX 3343, HICKORY, NC, 286033343, US | 259 SW CAPTAIN BROWN RD, MADISON, FL, 323404316, US | |||||||||||||||||||||||
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| Phone | +1 828-324-8898 |
| Fax | 8283229598 |
| Phone | +1 850-973-8277 |
| Fax | 8509734006 |
Authorized person
| Name | MR. STEVEN D WOMACK |
| Role | MANAGING MEMBER |
| Phone | 8283248898 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF16360961 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DOMINION HEALTH CARE OPERATOR, LLC | Manager | 1978 8TH AVE. NW, HICKORY, NC, 28601 |
| CAPITOL CORPORATE SERVICES, INC. | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-08-01 | 1978 8TH AVE. NW, HICKORY, NC 28601 | - |
| CHANGE OF MAILING ADDRESS | 2025-08-01 | 1978 8TH AVE. NW, HICKORY, NC 28601 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-01 | 1978 8TH AVE. NW, HICKORY, NC 28601 | - |
| CHANGE OF MAILING ADDRESS | 2024-08-01 | 1978 8TH AVE. NW, HICKORY, NC 28601 | - |
| LC WITHDRAWAL | 2009-11-09 | - | - |
| REVOKED FOR ANNUAL REPORT | 2009-09-25 | - | - |
| Name | Date |
|---|---|
| LC Withdrawal | 2009-11-09 |
| Foreign Limited | 2008-12-15 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
