| Entity Name: | CCRC - LAKE PORT SQUARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 21 May 2014 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Oct 2020 (4 years ago) |
| Document Number: | M14000003453 |
| FEI/EIN Number | 32-0441123 |
| Address: | 4600 S Syracuse Street, Ste 500, Denver, CO 80237 |
| Mail Address: | 4600 S Syracuse Street, Ste 500, Denver, CO 80237 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073927331 | 2014-06-16 | 2021-02-10 | 1920 MAIN ST STE 1200, IRVINE, CA, 926147230, US | 701 LAKE PORT BLVD, LEESBURG, FL, 347487674, US | |||||||||||||||
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| Phone | +1 949-407-0700 |
| Phone | +1 352-728-3366 |
Authorized person
| Name | JEFFREY MILLER |
| Role | CEO/PRESIDENT |
| Phone | 9494070700 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ct corporation system | Agent | 1200 South Pine Island Road, Plantation, FL 33324 |
| Name | Role | Address |
|---|---|---|
| CCRC OpCo Ventures, LLC | Member | 4600 S Syracuse Street, Ste 500, Denver, CO 80237 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000013839 | LAKE PORT SQUARE INN | ACTIVE | 2020-01-30 | 2025-12-31 | No data | 1920 MAIN STREET, SUITE 1200, IRVINE, CA, 92614 |
| G20000013840 | LAKE PORT SQUARE HEALTH CENTER | ACTIVE | 2020-01-30 | 2025-12-31 | No data | 1920 MAIN STREET, SUITE 1200, IRVINE, CA, 92614 |
| G14000103115 | LAKE HARRIS INN | EXPIRED | 2014-10-10 | 2024-12-31 | No data | 701 LAKE PORT BLVD, LEESBURG, FL, 34748 |
| G14000103111 | LAKE PORT SQUARE | EXPIRED | 2014-10-10 | 2024-12-31 | No data | 600 LAKE PORT BOULEVARD, LEESBURG, FL, 34748 |
| G14000103110 | LAKE HARRIS HEALTH CENTER | EXPIRED | 2014-10-10 | 2024-12-31 | No data | 701 LAKE PORT BLVD, LEESBURG, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-26 | 4600 S Syracuse Street, Ste 500, Denver, CO 80237 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-26 | 4600 S Syracuse Street, Ste 500, Denver, CO 80237 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-07-12 | 1200 South Pine Island Road, Plantation, FL 33324 | No data |
| REINSTATEMENT | 2020-10-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-02 | ct corporation system | No data |
| REVOKED FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC AMENDMENT | 2020-03-23 | No data | No data |
| LC STMNT OF RA/RO CHG | 2020-02-07 | No data | No data |
| LC STMNT OF RA/RO CHG | 2016-10-05 | No data | No data |
| Title | Case Number | Docket Date | Status | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| TERRY L. TROST, SR., AS PERSONAL REPRESENTATIVE OF THE ESTATE OF ROSS A. TROST VS CCRC-LAKE PORT SQUARE, LLC, BKD TWENTY-ONE MANAGEMENT COMPANY, INC., BROOKDALE SENIOR LIVING, INC., AND MARK H. DANIELS (AS TO LAKE HARRIS HEALTH CENTER) | 5D2020-0769 | 2020-03-20 | Closed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Name | Estate of Ross A. Trost |
| Role | Appellant |
| Status | Active |
| Name | Terry L. Trost, Sr., |
| Role | Appellant |
| Status | Active |
| Representations | Lisa M. Tanaka, Joanna Greber Dettloff, Megan Gisclar Colter |
| Name | CCRC - LAKE PORT SQUARE, LLC |
| Role | Appellee |
| Status | Active |
| Representations | Robin N. Khanal |
| Name | BROOKDALE SENIOR LIVING INC. |
| Role | Appellee |
| Status | Active |
| Name | Mark H. Daniels |
| Role | Appellee |
| Status | Active |
| Name | BKD TWENTY-ONE MANAGEMENT COMPANY, INC. |
| Role | Appellee |
| Status | Active |
| Name | Lake Harris Health Center |
| Role | Appellee |
| Status | Active |
| Name | Hon. Larry Metz |
| Role | Judge/Judicial Officer |
| Status | Active |
| Name | Lake Co Circuit Ct Clerk |
| Role | Lower Tribunal Clerk |
| Status | Active |
Docket Entries
| Docket Date | 2020-06-08 |
| Type | Mandate |
| Subtype | Notice Memorandum |
| Description | Notice Memorandum |
| Docket Date | 2020-06-08 |
| Type | Record |
| Subtype | Returned Records |
| Description | Returned Records ~ NO RECORD EFILED |
| Docket Date | 2020-05-20 |
| Type | Disposition |
| Subtype | Dismissed |
| Description | Dismissed - Order by Clerk |
| Docket Date | 2020-05-20 |
| Type | Order |
| Subtype | Order on Motion/Notice Voluntary Dismissal (non-dispositive) |
| Description | Order Granting Voluntary Dismissal |
| Docket Date | 2020-05-19 |
| Type | Motions Other |
| Subtype | Motion/Notice Voluntary Dismissal |
| Description | Notice of Voluntary Dismissal |
| On Behalf Of | Terry L. Trost, Sr., |
| Docket Date | 2020-05-13 |
| Type | Order |
| Subtype | Order on Motion to Stay |
| Description | ORD-Grant Stay ~ AA BY 6/11 FILE NTC VOL DISMISSAL OR MOT FOR EOT OF STAY... |
| Docket Date | 2020-05-05 |
| Type | Motions Other |
| Subtype | Motion To Stay |
| Description | Motion To Stay |
| On Behalf Of | Terry L. Trost, Sr., |
| Docket Date | 2020-04-03 |
| Type | Notice |
| Subtype | Notice of Agreed Extension of Time - Initial Brief |
| Description | Notice of Agreed Extension - Initial Brief ~ TO 5/6 |
| On Behalf Of | Terry L. Trost, Sr., |
| Docket Date | 2020-03-24 |
| Type | Notice |
| Subtype | Notice of Appearance |
| Description | Notice of Appearance |
| On Behalf Of | Terry L. Trost, Sr., |
| Docket Date | 2020-03-20 |
| Type | Misc. Events |
| Subtype | Miscellaneous Trial Court Order |
| Description | ORD-From Circuit Court/Agency |
| Docket Date | 2020-03-20 |
| Type | Letter |
| Subtype | Acknowledgment Letter |
| Description | Acknowledgement Letter 1 |
| Docket Date | 2020-03-20 |
| Type | Notice |
| Subtype | Notice of Appeal |
| Description | Notice of Appeal Filed ~ FILED BELOW 3/20/2020 |
| On Behalf Of | Terry L. Trost, Sr., |
| Docket Date | 2020-03-20 |
| Type | Order |
| Subtype | Order on Filing Fee |
| Description | Order to pay filing fee - Civil appeal (300) |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| AMENDED ANNUAL REPORT | 2023-08-30 |
| ANNUAL REPORT | 2023-04-26 |
| AMENDED ANNUAL REPORT | 2022-07-12 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-04-24 |
| REINSTATEMENT | 2020-10-02 |
| LC Amendment | 2020-03-23 |
| CORLCRACHG | 2020-02-07 |
| ANNUAL REPORT | 2019-04-29 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
