UNITED STATES BANKRUPTCY COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION In re LIFE CARE ST. JOHNS, INC., a Florida not-for-profit corporation doing business as GLENMOOR, 1 Debtor. Case No.: 3:13-bk-4158-JAF Chapter 11 NOTICE OF FILING PARTIAL MATRIX OF CREDITORS AND PARTIES IN INTEREST Life Care St. Johns, Inc., a Florida not-for-profit corporation doing business as Glenmoor ( Debtor, gives notice of filing of the attached partial matrix of creditors and parties in interest entitled to receive notices in this case. Debtor may be prohibited by the Health Insurance Portability and Accountability Act of 1996 from disclosing the names and addresses of its present, former or prospective residents and will be filing a motion to file such information under seal. STUTSMAN THAMES & MARKEY, P.A /s/ Richard R. Thames By Richard R. Thames Florida Bar Number 0718459 50 North Laura Street, Suite 1600 Jacksonville, Florida 32202 (904 358-4000 (904 358-4001 (Facsimile rrt@stmlaw.net Proposed attorneys for Life Care St. Johns, Inc., a Florida not-for-profit corporation doing business as Glenmoor 1 The Federal Employer Identification Number for the Debtor is 59-3474627. The address of the Debtor is 235 Towerview Drive, St. Augustine, Florida, 32092.
Certificate of Service I certify that, on July 9, 2013, a copy of the foregoing was filed electronically with the Court s CM/ECF filing system which will generate an electronic notice of filing to the Office of the United States Trustee, 135 W. Central Blvd., Room 620, Orlando, Florida 32280 and to all creditors and parties in interest who have consented to receiving electronic notices in this case. 143 /s/ Richard R. Thames Attorney
Abacus Carpentry, LLC 1008 Loring Ave., #29 Orange Park, FL 32073 Abacus Contracting, LLC 1008 Loring Ave., #29 Orange Park, FL 32073 Aetna P.O. Box 804735 Chicago, IL 60680-4108 Aetna - Middletown P.O. Box 532422 Charlotte, NC 28290-2422 All About Blinds 7501 Philips Hwy. All American Air Conditioning & Heating Contractors, Inc. 1010 S.R. 312 Saint Augustine, FL 32080 American Data Services P.O. Box 640 Sauk City, WI 53583 American Health Associates, Inc. 2831 Corporate Way Hollywood, FL 33025 Atkinson's Healthcare Providers Attn: Robert Allen, President P.O. Box 7023 Orange Park, FL 32073 Atlantic Self Storage 1975 S.R. 16 Saint Augustine, FL 32084 Beall, Jennifer L. Dysphagia Decision Solutions, LLC 4400 N. Alatamaha St. Saint Augustine, FL 32092 Blackwell, Jeffery E. 8883 Ivy Mill Pl. N Jacksonville, FL 32244 Bonura, Joseph W., DPM 19 Burning Sands Ln. Palm Coast, FL 32137-8808 Bunnell, Charlene, personal rep. for the Estate of Walter Bugeski Carames, Earnest, M.D. 16 St. Johns Medical Park Dr. Saint Augustine, FL 32086 Century Ambulance Service, Inc. Page 1
Attn: Melanie Delaney 2144 Rosselle St. Jacksonville, FL 32204 Cheney Brothers, Inc. One Cheney Way West Palm Beach, FL 33404-7000 City Electric Supply P.O. Box 609521 Orlando, FL 32810 Community Hospice of Northeast Florida, Inc. Attn: Compliance / Legal Dept. 4114 Sunbeam Rd., Bldg. 300 Jacksonville, FL 32257 Community Hospice of Northeast Florida, Inc. Attn: Carlos Bosque, Executive VP 4266 Sunbeam Rd. Jacksonville, FL 32257 Daniel S. Bleck, Esq. Mintz Levin One Financial Center Boston, MA 02111 Dysphagia Decision Solutions, Inc. 4400 N. Alatamaha St. Saint Augustine, FL 32092 Ecolab Pest Elimination 26252 Network Pl. Chicago, IL 60673-1262 Edward Don & Company 2500 S. Harlem Ave. Riverside, IL 60546 Facility Automation Solutions 524 Stockton St. Jacksonville, FL 32204 First Coast Cabinets, Inc. 6215 Wilson Blvd. Jacksonville, FL 32210 FL Department of Financial Service Attn: Timothy L. Newhall, Esq. 2020 Capital Circle SE Tallahassee, FL 32399-6539 FL Department of Financial Service Attn: Lourdes Calzadilla, Esq. 2020 Capital Circle SE Tallahassee, FL 32399-6539 FL Dept. of Revenue 5050 W. Tennessee St. Tallahassee, FL 32399 Page 2
FL Dept. of State Clifton Building 2661 Executive Center Dr. Tallahassee, FL 32301 FL Office of Insurance Regulation Attn: Dan Papka, Fin. Examiner 200 E. Gaines St. Tallahassee, FL 32399-0327 FL Office of Insurance Regulation Attn: Kevin M. McCarthy 200 E. Gaines St. Tallahassee, FL 32399-0305 Flagler Hospital, Inc. Attn: James D. Conzemius, Pres. 400 Health Park Blvd. Saint Augustine, FL 32086 Florida Dept. of Financial Service Bureau of Licensing Revenue Processing Section P.O. Box 6100 Tallahassee, FL 32314-6100 Florida Medical Quality Assurance Attn: Logan Malone, Ed.D., CEO 4350 W. Cypress St., #900 Tampa, FL 33607-4151 Florida Power & Light Co. P.O. Box 025576 Miami, FL 33102 FPL Energy Services P.O. Box 25426 Miami, FL 33102-5426 FreshPoint, Inc. 3100 Hilton St. Jacksonville, FL 32209 Garden Wholesale, Inc., The 280 Hastings Rd. Saint Augustine, FL 32084 Hair & Beauty Spa of Glenmoor 305 Oleander Neptune Beach, FL 32266 HD Supply Facilities Maintenance P.O. Box 509058 San Diego, CA 92150-9058 Hershey's Ice Cream 1089 Jetstream Dr. Orlando, FL 32824 Hill's Home Care, Inc. 9191 R.G. Skinner Pkwy., #803 Page 3
Hoffman, Michael 7128 Greenfern Ln. Jacksonville, FL 32277 Home Depot Credit Services P.O. Box 9101 Des Moines, IA 50368 Humana Insurance Co. P.O. Box 533 Carol Stream, IL 60132-0533 Int Med Assoc. of St. Johns County 16 St. Johns Medical Park Dr. Saint Augustine, FL 32086 Internal Revenue Service P.O. Box 7346 Philadelphia, PA 19101-7346 Isaac Garvin Construction, Inc. 362 Commerce Way, #120 Longwood, FL 32750 J&L Koscoe Corp. 5960 U.S. 1 N Saint Augustine, FL 32095-8007 Jacksonville Mobile Imaging Serv. First Coast Mobile Imaginge Serv. 4237 Salisbury Rd., #306 Jacksonville, FL 32216 Jax Home Health, Inc. 9191 R.G. Skinner Pkwy., #803 Lamp Sales Unlimited, Inc. 4580 St. Augustine Rd. Jacksonville, FL 32207 LCPS Management, Inc. 1000 Vicar's Landing Way Ponte Vedra Beach, FL 32082 Life Care Ponte Vedra, Inc. d/b/a Vicar's Landing 1000 Vicars Landing Way Ponte Vedra Beach, FL 32082 Lifetime Enclosures 5521 Chronicle Ct. Lloyd S. Manukian, Esq. Farah & Farah, P.A. 1301 Plantation Island Dr., #206A Saint Augustine, FL 32080 Lucks, Sharon 4743 Seaboard Ave. Jacksonville, FL 32210 Page 4
Lucks, Sharon, RD, LD 4743 Seaboard Ave. Jacksonville, FL 32210 Masco Contractor Services Central d/b/a Vern's Insulation & Special P.O. Box 754 New Smyrna Beach, FL 32170 Mayport C&C Fisheries 36 W. 6th St. Atlantic Beach, FL 32233 McKesson Red Line Extended Care P.O. Box 630693 Cincinnati, OH 45263-0693 Medco, Inc. 653 Kingsley Ave. Orange Park, FL 32073 Nader's Pest Raiders P.O. Box 3399 Ponte Vedra Beach, FL 32004-3399 Nanek's Landscaping Grounds Maintenance, Inc. 11530 Davis Creek Ct. Office Depot P.O. Box 633211 Cincinnati, OH 45263-3211 Old Dominion Insurance Company P.O. Box 731178 Dallas, TX 75373-1178 On Shift, Inc. 1621 Euclid Ave., #1500 Cleveland, OH 44115 Otis Elevator Company 6631 Executive Park Ct. Jacksonville, FL 32216 Pitney Bowes Global Financial Serv P.O. Box 371887 Pittsburgh, PA 15250-7887 ProMed Waste Solutions 320 Enterprise St. Ocoee, FL 34761-3002 Publix Customer Charge P.O. Box 32009 Lakeland, FL 33802 Richard Saelenski 5428 Deleon Ln. Elkton, FL 32033 Page 5
Ring Power Corporation P.O. Box 935004 Atlanta, GA 31193-5004 Royal Cup Dine-Mor, Inc. P.O. Box 170971 Birmingham, AL 35217 RT Publishing, Inc. 12443 San Jose Blvd., #403 Jacksonville, FL 32223 Shredding Source, Inc. P.O. Box 551467 Jacksonville, FL 32255 Simplex Grinnell Dept. CH 10320 Palatine, IL 60055-0320 SimplexGrinnell 10255 Fortune Pkwy., #120 Sirius XM Radio, Inc. P.O. Box 9001399 Louisville, KY 40290-1399 Smart Stream IT Solutions 2771-29 Monument Rd., #302 Jacksonville, FL 32225 Southeastern Paper Group LockBox 231805 1805 Momentum Pl. Chicago, IL 60689-5318 Southeastern Paper Group, Inc. P.O. Box 330 Browns Summit, NC 27214 Southern Wines & Spirits P.O. Box 90249 Lakeland, FL 33804-0249 St. Johns County Industrial Development Authority 4020 Lewis Speedway Saint Augustine, FL 32095 St. Johns County Tax Collector P.O. Box 9001 Saint Augustine, FL 32085-9001 St. JOhns County Utility Dept. P.O. Drawer 3006 St. Augustine, FL 32085-3006 Stephen R. Senn, Esq. Peterson & Myers, P.A. P.O. Box 24628 Lakeland, FL 33802-4628 Page 6
Sun Life Assurance Company Canada P.O. Box 7247-0381 Philadelphia, PA 19170-0381 Sysco - SFS Jacksonville, Inc. P.O. Box 37045 Jacksonville, FL 32236 T.G. Lee Foods P.O. Box 932689 Atlanta, GA 31193-2689 Trayco of S.C., Inc. P.O. Box 404284 Atlanta, GA 30384-4284 United Healthcare Specialty Benefi P.O. Box 2485 Carol Stream, IL 60132-2485 Valley Crest P.O. Box 404083 Atlanta, GA 30384-4083 Value First, Inc. 2550 University Ave. W, #350 South Saint Paul, MN 55114 W.W. Gay Mechanics Construction 524 Stockton St. Jacksonville, FL 32204 Wells Fargo Bank, N.A., as trustee Attn: Michael Slade 625 Marqueete Ave., 11th Fl. Minneapolis, MN 55479 Page 7