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RESIDENTIAL CARE XII, L.L.C.

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Company Details

Name: RESIDENTIAL CARE XII, L.L.C.
Legal type: Foreign Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 12 Jun 2014 (11 years ago)
Authority Date: 12 Jun 2014 (11 years ago)
Last Annual Report: 05 Jun 2023 (2 years ago)
Organization Number: 0889617
Principal Office: 6900 SOUTH GRAY ROAD, INDIANAPOLIS, IN 46237
Place of Formation: INDIANA

Member

Name Role
Gregg Family LLLP Member
KEJ 6900, LLC Member
DRJ, LP II Member
WEJ IV, LP Member
Abishai VI, LP Member
MBJ FLP Member
Shelly Todd Member

Registered Agent

Name Role
KY SECRETARY OF STATE Registered Agent

National Provider Identifier

NPI Number:
1134733686
Certification Date:
2020-09-25

Authorized Person:

Name:
STEVE VAN CAMP
Role:
CFO OF ASC
Phone:

Taxonomy:

Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Fax:
5023130299

Assumed Names

Name Status Expiration Date
FOREST HILLS COMMONS Inactive 2024-11-08

Filings

Name File Date
Revocation of Certificate of Authority 2024-10-12
Registered Agent name/address change 2023-09-18
Annual Report 2023-06-05
Annual Report 2022-06-06
Annual Report 2021-06-28

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Sources: Kentucky Secretary of State