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STILL WATERS OF LAKE CITY, INC. - Florida Company Profile

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Company Details

Entity Name: STILL WATERS OF LAKE CITY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
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: 18 Apr 2001 (24 years ago)
Date of dissolution: 21 Apr 2022 (3 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 21 Apr 2022 (3 years ago)
Document Number: N01000002771
FEI/EIN Number 593717525

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

Address: 217 SW Dyal Ave, LAKE CITY, FL, 32024, US
Mail Address: c/o 217 SW Dyal Ave, LAKE CITY, FL, 32024, US
ZIP code: 32024
City: Lake City
County: Columbia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
ELLIS EVERETT W Director PO BOX 3384, LAKE CITY, FL, 32056
HYSELL THREASA Treasurer 1661 SW ST JAMES CT, LAKE CITY, FL, 32025
HYSELL THREASA Director 1661 SW ST JAMES CT, LAKE CITY, FL, 32025
HYSELL THREASA M Agent 1661 SW ST JAMES CT., LAKE CITY, FL, 32025
JOHNS LONNIE R Director 2512 SW Family Road, Lulu, FL, 32061
ELLIS EVERETT W Vice President PO BOX 3384, LAKE CITY, FL, 32056
JOHNS LONNIE R President 2512 SW Family Road, Lulu, FL, 32061

National Provider Identifier

NPI Number:
1104160027

Authorized Person:

Name:
THREASA HYSELL
Role:
EXECUTIVE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
311500000X - Alzheimer Center (Dementia Center)
Is Primary:
No
Selected Taxonomy:
311ZA0620X - Adult Care Home Facility
Is Primary:
No
Selected Taxonomy:
385H00000X - Respite Care
Is Primary:
No
Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Fax:
3866285018

Form 5500 Series

Employer Identification Number (EIN):
593717525
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
30
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
28
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2022-04-21 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 - -
CHANGE OF PRINCIPAL ADDRESS 2019-05-03 217 SW Dyal Ave, LAKE CITY, FL 32024 -
CHANGE OF MAILING ADDRESS 2019-05-03 217 SW Dyal Ave, LAKE CITY, FL 32024 -
REGISTERED AGENT ADDRESS CHANGED 2003-04-17 1661 SW ST JAMES CT., LAKE CITY, FL 32025 -

Documents

Name Date
VOLUNTARY DISSOLUTION 2022-04-21
ANNUAL REPORT 2019-05-03
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-04-21
ANNUAL REPORT 2015-04-28
ANNUAL REPORT 2014-04-25
ANNUAL REPORT 2013-04-29
ANNUAL REPORT 2012-04-18
ANNUAL REPORT 2011-03-21

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Date of last update: 01 Jul 2025

Sources: Florida Department of State