0001684778-16-000001.txt : 20160919 0001684778-16-000001.hdr.sgml : 20160919 20160919161312 ACCESSION NUMBER: 0001684778-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160919 DATE AS OF CHANGE: 20160919 EFFECTIVENESS DATE: 20160919 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PROVEST CROSS COUNTRY VILLAGE, LLC CENTRAL INDEX KEY: 0001684778 IRS NUMBER: 000000000 STATE OF INCORPORATION: NC FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-270905 FILM NUMBER: 161891874 BUSINESS ADDRESS: STREET 1: 9 ISLAND AVENUE, SUITE 1208 CITY: MIAMI BEACH STATE: FL ZIP: 33139 BUSINESS PHONE: 305-538-9373 MAIL ADDRESS: STREET 1: 9 ISLAND AVENUE, SUITE 1208 CITY: MIAMI BEACH STATE: FL ZIP: 33139 D 1 primary_doc.xml X0707 D LIVE 0001684778 PROVEST CROSS COUNTRY VILLAGE, LLC 9 ISLAND AVENUE, SUITE 1208 MIAMI BEACH FL FLORIDA 33139 305-538-9373 NORTH CAROLINA None None Limited Liability Company true 2016 Mark Salomon 9 Island Avenue, Suite 1208 Miami Beach FL FLORIDA 33139 Director Charles Vita 9 ISland Avenue, Suite 1208 Miami Beach FL FLORIDA 33139 Executive Officer Commercial Decline to Disclose 06b false 2016-08-24 false true CLASS B MEMBERSHIP INTEREST false 0 none None None None NONE NONE XX Unknown 00000 FL FLORIDA NJ NEW JERSEY NY NEW YORK false 545913 545913 0 false 12 0 0 0 false PROVEST CROSS COUNTRY VILLAGE, LLC Charles A. Vita Charles A. Vita Manager 2016-09-19