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CARLTON SHORES NH LLC - Florida Company Profile

Company Details

Entity Name: CARLTON SHORES NH LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 29 Jan 2010 (15 years ago)
Document Number: M10000000412
FEI/EIN Number 271842333

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1350 S NOVA ROAD, DAYTONA BEACH, FL, 32114-5812
Mail Address: 1350 South Nova Road, 4042 PARK OAKS BLVD., SUITE 300, Daytona Beach, FL, 32114, US
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1588986368 2010-02-22 2011-06-20 1350 S NOVA RD, DAYTONA BEACH, FL, 321145812, US 1350 S NOVA RD, DAYTONA BEACH, FL, 321145812, US

Contacts

Phone +1 386-258-5544
Fax 3862555623

Authorized person

Name MR. WILLIAM P MANDO
Role CFO
Phone 8136359500

Taxonomy

Taxonomy Code 310400000X - Assisted Living Facility
License Number 6110
State FL
Is Primary No
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 002213800
State FL
Is Primary Yes
Taxonomy Code 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME)
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 002213800
State FL

Key Officers & Management

Name Role Address
NH Operator Holdings II LLC Auth 400 Rella blvd, Montebello, NY, 10901
CORPORATION SERVICE COMPANY Agent -

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000016910 CARLTON SHORES HEALTH AND REHABILITATION CENTER ACTIVE 2010-02-22 2025-12-31 - 4042 PARK OAKS BLVD, 4042 PARK OAKS BLVD., SUITE 300, LAKELAND, FL, 33810

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2021-03-04 1350 S NOVA ROAD, DAYTONA BEACH, FL 32114-5812 -
CHANGE OF PRINCIPAL ADDRESS 2011-04-22 1350 S NOVA ROAD, DAYTONA BEACH, FL 32114-5812 -

Documents

Name Date
ANNUAL REPORT 2024-02-13
ANNUAL REPORT 2023-03-14
AMENDED ANNUAL REPORT 2022-06-23
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-03-04
ANNUAL REPORT 2020-04-07
ANNUAL REPORT 2019-03-06
ANNUAL REPORT 2018-03-21
ANNUAL REPORT 2017-03-17
ANNUAL REPORT 2016-04-25

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
345856363 0419700 2022-03-24 1350 S NOVA RD., DAYTONA BEACH, FL, 32114
Inspection Type Monitoring
Scope Partial
Safety/Health Health
Close Conference 2022-06-01
Emphasis N: COVID-19
Case Closed 2022-06-01

Related Activity

Type Complaint
Activity Nr 1549202
Health Yes

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3315598600 2021-03-16 0491 PPP 1350 S Nova Rd, Daytona Beach, FL, 32114-5812
Loan Status Date 2021-03-31
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1077050
Loan Approval Amount (current) 1077050
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46391
Servicing Lender Name Manufacturers and Traders Trust Company
Servicing Lender Address One M & T Plaza, 15th Fl, BUFFALO, NY, 14203
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Daytona Beach, VOLUSIA, FL, 32114-5812
Project Congressional District FL-06
Number of Employees 118
NAICS code 623110
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 15793
Originating Lender Name Manufacturers and Traders Trust Company
Originating Lender Address Bridgeport, CT
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 1089266.4
Forgiveness Paid Date 2022-05-12

Date of last update: 01 Mar 2025

Sources: Florida Department of State