0001900832-22-000001.txt : 20220201 0001900832-22-000001.hdr.sgml : 20220201 20220201130734 ACCESSION NUMBER: 0001900832-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220201 DATE AS OF CHANGE: 20220201 EFFECTIVENESS DATE: 20220201 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ASC Lake Hills LLC CENTRAL INDEX KEY: 0001900832 IRS NUMBER: 851050734 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-431702 FILM NUMBER: 22577935 BUSINESS ADDRESS: STREET 1: 415 118TH AVENUE SE CITY: BELLEVUE STATE: WA ZIP: 98005 BUSINESS PHONE: (425) 861-9993 MAIL ADDRESS: STREET 1: 415 118TH AVENUE SE CITY: BELLEVUE STATE: WA ZIP: 98005 D 1 primary_doc.xml X0708 D LIVE 0001900832 ASC Lake Hills LLC 415 118TH AVENUE SE BELLEVUE WA WASHINGTON 98005 (425) 861-9993 WASHINGTON ASC Bellevue-16th Street LLC None Limited Liability Company true 2020 Dwayne Clark 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Promoter Jerry C. Meyer 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Edward J. Poplawski 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Adam Clark 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Ashley Rea 415 118th Avenue SE Bellevue WA WASHINGTON 98005 Executive Officer Other Health Care Decline to Disclose 06b false 2022-01-25 false true false 0 6940000 6940000 0 false 21 0 0 0 false ASC Lake Hills LLC /s/ Ben Freeburg Ben Freeburg Authorized Signatory 2022-01-31