| Entity Name: | NORTHBROOK SKILLED NURSING FACILITY, LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 27 Jul 2015 |
| Company Number: | LLC_05349206 |
| File Number: | 05349206 |
| Type of Management: | Manager Managed |
| Date Status Change: | 17 Jun 2024 |
| Address | 3450 OAKTON STREET, SKOKIE, 60076, IL |
| Place of Formation: | ILLINOIS |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| G8M9AD9SQKA9 | 2024-09-14 | 263 SKOKIE BLVD, NORTHBROOK, IL, 60062, 1611, USA | 3450 OAKTON STREET, SKOKIE, IL, 60076, USA | |||||||||||||||||||||||||||||||||||||||
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| Division Name | LEGACY HEALTHCARE |
| Division Number | LEGACY HEA |
| Congressional District | 10 |
| State/Country of Incorporation | IL, USA |
| Activation Date | 2023-09-19 |
| Initial Registration Date | 2016-09-12 |
| Entity Start Date | 2015-11-01 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | ANNA HINTZ |
| Address | 3450 OAKTON ST, SKOKIE, IL, 60076, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SCOTT SCHAYER |
| Address | 3450 OAKTON ST., SKOKIE, IL, 60076, USA |
| Past Performance | Information not Available |
|---|
| Name and Address | Role | Appointment Date |
|---|---|---|
| ILLINOIS CORPORATION SERVICE COMPANY, 801 ADLAI STEVENSON DRIVE, SPRINGFIELD, 62703, SANGAMON | Agent | 2016-05-12 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| LEGACY HEALTHCARE FINANCIAL SERVICES, LLC, 3450 OAKTON STREET, SKOKIE, IL, 60076 | Manager | 2024-06-17 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| THE GROVE OF NORTHBROOK | Assumed name | 2015-08-03 | No data | No data | 2020-05-28 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | 36C25224K0149 | 2023-10-01 | 2024-09-30 | 2024-09-30 | |||||||||||||||||||||||||
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| Obligated Amount | 201175.01 |
| Current Award Amount | 201175.01 |
| Potential Award Amount | 201175.01 |
Description
| Title | EXPRESS REPORT: FY24 1358 COST REPORTING OCTOBER 1, 2023 -SEPTEMBER 30, 2024 |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | NORTHBROOK SKILLED NURSING FACILITY LLC |
| UEI | G8M9AD9SQKA9 |
| Recipient Address | UNITED STATES, 263 SKOKIE BLVD, NORTHBROOK, COOK, ILLINOIS, 600621611 |
Date of last update: 23 Dec 2024
