0001692113-16-000001.txt : 20161214 0001692113-16-000001.hdr.sgml : 20161214 20161214162729 ACCESSION NUMBER: 0001692113-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161214 DATE AS OF CHANGE: 20161214 EFFECTIVENESS DATE: 20161214 FILER: COMPANY DATA: COMPANY CONFORMED NAME: CCRC of Overland Park, LLC CENTRAL INDEX KEY: 0001692113 IRS NUMBER: 814617194 STATE OF INCORPORATION: KS FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-276290 FILM NUMBER: 162051381 BUSINESS ADDRESS: STREET 1: 11827 W 112TH STREET, SUITE 103 CITY: OVERLAND PARK STATE: KS ZIP: 66210 BUSINESS PHONE: (913) 599-5705 MAIL ADDRESS: STREET 1: 11827 W 112TH STREET, SUITE 103 CITY: OVERLAND PARK STATE: KS ZIP: 66210 D 1 primary_doc.xml X0707 D LIVE 0001692113 CCRC of Overland Park, LLC 11827 W 112TH STREET, SUITE 103 OVERLAND PARK KS KANSAS 66210 (913) 599-5705 KANSAS None None Limited Liability Company true 2016 Devlopment LLC Scenic 11827 W 112th Street, Suite 103 Overland Park KS KANSAS 66210 Director Manager of CCRC of Cedar Rapids Gilbert Wood 11827 W 112th Street, Suite 103 Overland Park KS KANSAS 66210 Executive Officer CEO of Scenic Development, LLC Wayne Anderson 11827 W 112th Street, Suite 103 Overland Park KS KANSAS 66210 Director Vice President of Scenic Development, LLC Scott Gulledge 11827 W 112th Street, Suite 103 Overland Park KS KANSAS 66210 Director COO of Scenic Development, LLC Jordan Anderson 11827 W 112th Street, Suite 103 Overland Park KS KANSAS 66210 Executive Officer Vice President of CCRC of Overland Park, LLC Other Health Care Decline to Disclose 06b false 2016-11-30 false true false 90000 15390000 360000 15030000 false 1 0 0 0 false CCRC of Overland Park, LLC /s/ Jordan Anderson Jordan Anderson Vice President of CCRC of Overland Park, LLC 2016-12-14