0001699232-17-000002.txt : 20170331 0001699232-17-000002.hdr.sgml : 20170331 20170331164022 ACCESSION NUMBER: 0001699232-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170331 DATE AS OF CHANGE: 20170331 EFFECTIVENESS DATE: 20170331 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Sand Lake SurgiCenter, LLC CENTRAL INDEX KEY: 0001699232 IRS NUMBER: 000000000 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-283840 FILM NUMBER: 17730918 BUSINESS ADDRESS: STREET 1: 569 BROOKWOOD VILLAGE STREET 2: SUITE 901 CITY: BIRMINGHAM STATE: AL ZIP: 35209 BUSINESS PHONE: 205-545-2734 MAIL ADDRESS: STREET 1: 569 BROOKWOOD VILLAGE STREET 2: SUITE 901 CITY: BIRMINGHAM STATE: AL ZIP: 35209 D 1 primary_doc.xml X0707 D LIVE 0001699232 Sand Lake SurgiCenter, LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL ALABAMA 35209 205-545-2734 FLORIDA None None Limited Liability Company true N/A SCA-Sand Lake, LLC 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Director Mananger Andrew P. Hayek 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Joseph T. Clark 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Richard L. Sharff, Jr. 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Michael A. Rucker 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Tom De Weerdt 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Other Health Care Decline to Disclose 06b false 2017-03-16 false true false 0 N/A None SCA Development, LLC 35451 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 FL FLORIDA false 605000 55000 550000 false 1 0 0 0 false Sand Lake SurgiCenter, LLC /s/ McCauley Williams, Esq. McCauley Williams, Esq. Attorney for Issuer 2017-03-31