| Entity Name: | CCRC - LAKE PORT SQUARE, 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: | 21 May 2014 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Oct 2020 (5 years ago) |
| Document Number: | M14000003453 |
| FEI/EIN Number |
32-0441123
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4600 S Syracuse Street, Ste 500, Denver, CO, 80237, US |
| Mail Address: | 4600 S Syracuse Street, Ste 500, Denver, CO, 80237, US |
| 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 |
|---|---|---|
| CCRC OpCo Ventures, LLC | Member | 4600 S Syracuse Street, Ste 500, Denver, CO, 80237 |
| ct corporation system | Agent | 1200 South Pine Island Road, Plantation, FL, 33324 |
| 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 | - | 1920 MAIN STREET, SUITE 1200, IRVINE, CA, 92614 |
| G20000013840 | LAKE PORT SQUARE HEALTH CENTER | ACTIVE | 2020-01-30 | 2025-12-31 | - | 1920 MAIN STREET, SUITE 1200, IRVINE, CA, 92614 |
| G14000103115 | LAKE HARRIS INN | EXPIRED | 2014-10-10 | 2024-12-31 | - | 701 LAKE PORT BLVD, LEESBURG, FL, 34748 |
| G14000103111 | LAKE PORT SQUARE | EXPIRED | 2014-10-10 | 2024-12-31 | - | 600 LAKE PORT BOULEVARD, LEESBURG, FL, 34748 |
| G14000103110 | LAKE HARRIS HEALTH CENTER | EXPIRED | 2014-10-10 | 2024-12-31 | - | 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 | - |
| CHANGE OF MAILING ADDRESS | 2023-04-26 | 4600 S Syracuse Street, Ste 500, Denver, CO 80237 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-07-12 | 1200 South Pine Island Road, Plantation, FL 33324 | - |
| REINSTATEMENT | 2020-10-02 | - | - |
| REGISTERED AGENT NAME CHANGED | 2020-10-02 | ct corporation system | - |
| REVOKED FOR ANNUAL REPORT | 2020-09-25 | - | - |
| LC AMENDMENT | 2020-03-23 | - | - |
| LC STMNT OF RA/RO CHG | 2020-02-07 | - | - |
| LC STMNT OF RA/RO CHG | 2016-10-05 | - | - |
| 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 | 2020-05-20 |
| Type | Disposition |
| Subtype | Dismissed |
| Description | Dismissed - Order by Clerk |
| 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) |
| Docket Date | 2020-06-08 |
| Type | Record |
| Subtype | Returned Records |
| Description | Returned Records ~ NO RECORD EFILED |
| Docket Date | 2020-05-20 |
| Type | Order |
| Subtype | Order on Motion/Notice Voluntary Dismissal (non-dispositive) |
| Description | Order Granting Voluntary Dismissal |
| 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 |
| USDOT Number | Carrier Operation | MCS-150 Form Date | MCS-150 Mileage | MCS-150 Year | Power Units | Drivers | Operation Classification | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3420807 | Intrastate Non-Hazmat | 2024-05-13 | 150 | 2023 | 3 | 7 | Priv. Pass. (Business) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Total Number of Inspections for the measurement period (24 months) | 0 |
| Driver Fitness BASIC Serious Violation Indicator | No |
| Vehicle Maintenance BASIC Acute/Critical Indicator | No |
| Unsafe Driving BASIC Acute/Critical Indicator | No |
| Driver Fitness BASIC Roadside Performance measure value | 0 |
| Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value | 0 |
| Total Number of Driver Inspections for the measurment period | 0 |
| Vehicle Maintenance BASIC Roadside Performance measure value | 0 |
| Total Number of Vehicle Inspections for the measurement period | 0 |
| Controlled Substances and Alcohol BASIC Roadside Performance measure value | 0 |
| Unsafe Driving BASIC Roadside Performance Measure Value | 0 |
| Number of inspections with at least one Driver Fitness BASIC violation | 0 |
| Number of inspections with at least one Hours-of-Service BASIC violation | 0 |
| Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation | 0 |
| Number of inspections with at least one Vehicle Maintenance BASIC violation | 0 |
| Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation | 0 |
| Number of inspections with at least one Controlled Substances and Alcohol BASIC violation | 0 |
| Number of inspections with at least one Unsafe Driving BASIC violation | 0 |
Safety Measurement System - Passenger Transportation
| Total Number of Inspections for the measurement period (24 months) | 0 |
| Driver Fitness BASIC Acute/Critical Indicator | No |
| Driver Fitness BASIC Roadside Performance Percentile | Less than 5 driver inspections |
| Vehicle Maintenance BASIC Acute/Critical Indicator | No |
| Vehicle Maintenance BASIC Roadside Performance Percentile | Less than 5 vehicle inspections |
| Controlled Substances and Alcohol BASIC Acute/Critical Indicator | No |
| Unsafe Driving BASIC Acute/Critical Indicator | No |
| Controlled Substances and Alcohol BASIC Roadside Performance Percentile | 0% |
| Unsafe Driving BASIC Roadside Performance Percentile | 0% |
| Driver Fitness BASIC Roadside Performance measure value | 0 |
| Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value | 0 |
| Total Number of Driver Inspections for the measurment period | 0 |
| Driver Fitness BASIC Roadside Performance Over Threshold Indicator | No |
| Vehicle Maintenance BASIC Roadside Performance measure value | 0 |
| Total Number of Vehicle Inspections for the measurement period | 0 |
| Vehicle Maintenance BASIC Roadside Performance Over Threshold Indicator | No |
| Controlled Substances and Alcohol BASIC Roadside Performance measure value | 0 |
| Unsafe Driving BASIC Roadside Performance Measure Value | 0 |
| Controlled Substances and Alcohol BASIC Roadside Performance Over Threshold Indicator | No |
| Driver Fitness BASIC Indicator | No |
| Number of inspections with at least one Driver Fitness BASIC violation | 0 |
| Number of inspections with at least one Hours-of-Service BASIC violation | 0 |
| Unsafe Driving BASIC Roadside Performance Over Threshold Indicator | No |
| Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation | 0 |
| Vehicle Maintenance BASIC Indicator | No |
| Number of inspections with at least one Vehicle Maintenance BASIC violation | 0 |
| Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation | 0 |
| Controlled Substances and Alcohol BASIC Indicator | No |
| Number of inspections with at least one Controlled Substances and Alcohol BASIC violation | 0 |
| Unsafe Driving Overall BASIC Indicator | No |
| Number of inspections with at least one Unsafe Driving BASIC violation | 0 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
