| Entity Name: | LAKE GIBSON VILLAGE, 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: | 02 Mar 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2024 (7 months ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (7 months ago) |
| Document Number: | M17000001885 |
| FEI/EIN Number |
820590161
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 444 Seabreeze Blvd, Suite 200, Daytona Beach, FL, 32118, US |
| Mail Address: | 444 Seabreeze Blvd, Suite 200, Daytona Beach, FL, 32118, US |
| ZIP code: | 32118 |
| County: | Volusia |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427547025 | 2018-05-09 | 2018-05-09 | 771 CARPENTERS WAY, LAKELAND, FL, 338093922, US | 771 CARPENTERS WAY, LAKELAND, FL, 338093922, US | |||||||||||||||||
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| Phone | +1 850-766-3712 |
Authorized person
| Name | RENEE TUCKER |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 8507663712 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 13081 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COOK SANDRA J | Manager | 14 ELIZABETH LANE, DAYTONA BEACH, FL, 32118 |
| Dyer Eileen T | Chief Executive Officer | 21 Ocean Ridge Blvd S., Palm Coast, FL, 32137 |
| Anderson David C | Manager | 444 Seabreeze Blvd, Daytona Beach, FL, 32118 |
| ANDERSON DAVID C | Agent | 444 Seabreeze Blvd., DAYTONA BEACH, FL, 32118 |
| GDAF MANAGEMENT, LLC | Manager | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000056446 | LAKE GIBSON VILLAGE | EXPIRED | 2017-05-23 | 2022-12-31 | - | 771 CARPENTERS WAY, LAKELAND, FL, 33809 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2024-09-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2022-11-07 | ANDERSON, DAVID C | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-22 | 444 Seabreeze Blvd, Suite 200, Daytona Beach, FL 32118 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-22 | 444 Seabreeze Blvd, Suite 200, Daytona Beach, FL 32118 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-20 | 444 Seabreeze Blvd., 200, DAYTONA BEACH, FL 32118 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-01-24 |
| AMENDED ANNUAL REPORT | 2022-11-07 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-07-20 |
| Foreign Limited | 2017-03-02 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2188017302 | 2020-04-29 | 0455 | PPP | 771 CARPENTERS WAY, LAKELAND, FL, 33809 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
