0001644790-15-000001.txt : 20150612 0001644790-15-000001.hdr.sgml : 20150612 20150612171800 ACCESSION NUMBER: 0001644790-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150612 DATE AS OF CHANGE: 20150612 EFFECTIVENESS DATE: 20150612 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Michigan Endoscopy Center at Providence Park, LLC CENTRAL INDEX KEY: 0001644790 IRS NUMBER: 455323684 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-241712 FILM NUMBER: 15929383 BUSINESS ADDRESS: STREET 1: 47601 GRAND RIVER AVENUE CITY: NOVI STATE: MI ZIP: 48374 BUSINESS PHONE: 215-589-9024 MAIL ADDRESS: STREET 1: 47601 GRAND RIVER AVENUE CITY: NOVI STATE: MI ZIP: 48374 D 1 primary_doc.xml X0707 D LIVE 0001644790 Michigan Endoscopy Center at Providence Park, LLC 47601 GRAND RIVER AVENUE NOVI MI MICHIGAN 48374 215-589-9024 MICHIGAN None None Limited Liability Company true 2012 Karen Sablyak 47601 Grand River Avenue Novi MI MICHIGAN 48374 Executive Officer Mark DeVore 47601 Grand River Avenue Novi MI MICHIGAN 48374 Executive Officer Peter Karadjoff 47601 Grand River Avenue Novi MI MICHIGAN 48374 Executive Officer Director Gerald Gilman 47601 Grand River Avenue Novi MI MICHIGAN 48374 Director Other Health Care Decline to Disclose 06b false 2013-02-01 false true false 0 500000 500000 0 false 2 0 0 0 false Michigan Endoscopy Center at Providence Park, LLC /s/ Karen Sablyak Karen Sablyak Treasurer 2015-06-09