Provider Profile
PARKSIDE ASSISTED LIVING AND MEMORY COTTAGE
Assisted Living Facility
FACILITY PROFILE
Street Address
- 2595 HARBOR BLVD
PORT CHARLOTTE, FL 33952
County: Charlotte - Phone: (941) 766-7444
Mailing Address
- 2595 HARBOR BLVD
PORT CHARLOTTE, FL 33952
County: Charlotte - Phone: (941) 766-7444
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Facility Information:
| Facility/Provider Type: | Assisted Living Facility | |||||||||
| Administrator: | MARK ACKERMAN | |||||||||
| Financial Officer: | MATT JOHNSON | |||||||||
| Owner/Licensee: | 2595 HARBOR BLVD LLC | |||||||||
| Owner/Licensee Since: | 2/2/2022 | |||||||||
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| Profit Status: | For-Profit | |||||||||
| Management Company: | Surpass Senior Living, LLC | |||||||||
| Manager Since: | 4/1/2024 | |||||||||
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| Licensed Beds: | 94 | |||||||||
| Bed Types: | Private: 94 Optional State Supplement: 0 Total Capacity: 94 Extended Congregate Care: 0 | |||||||||
| AHCA Number (File Number): | 11969264 | |||||||||
| AHCA Field Office: | 08 | |||||||||
| License Number: | 13075 | |||||||||
| Current License Effective: | 2/2/2024 | |||||||||
| Current License Expires: | 2/1/2026 | |||||||||
| License Status: | LICENSED | |||||||||
Services/Characteristics
| Medicaid Services: | Assistive Care Services |
| Activities: | Arts and CraftsCooking ClassesExercise ClassesGames/CardsGardeningMusic ProgramsSocial Events/Outings |
| Bed Hold Policy: | Facility will hold beds during a temporary absence |
| Adult Day Care Services: | No |
| Continuing Care Retirement Community: | No |
| Languages Spoken: | English |
| Nurse Availability: | Direct Part-Time |
| Payment Forms Accepted: | Other |
| Special Programs and Services: | Memory Care |
Emergency Power Plan Summary
| Onsite Alternate Power Source: | Fixed Generator |
| Emergency Power Supports: | Air ConditioningHeating SystemsLife Safety SystemsLightsRefrigeration |
| Plan Approval: | 9/10/2018 |
| Implementation Date: | 9/10/2018 |
| Cooling Method: | Air Conditioner |
| Areas Cooled: | Other Area |
| Areas Cooled Location: | Within Facility |
| Square Footage Cooled: | 7073 |
| Number of People to use Cooled Space: | 243 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 8/2/2023 | 2023012030 | Fine | Survey | $500.00 | 9/18/2023 |
| Change of ownership occurred 2/2/2022 | |||||
| 8/20/2018 | 2019005298 | Fine | Reporting | $50.00 | 5/29/2019 |
| 8/1/2018 | 2018011350 | Fine | Licensure | $250.00 | 2/26/2019 |
Important information and facility/provider definitions can be found in the Glossary.
Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.