| Name: | Self Skilled Nursing, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 May 2021 (4 years ago) |
| Entity Number: | 000-861-486 |
| Register Number: | 000861486 |
| ZIP code: | 36801 |
| County: | Lee |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 219 S. 8th StreetOpelika, AL 36801 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215503420 | 2021-05-28 | 2021-05-28 | 219 S 8TH ST, OPELIKA, AL, 368014915, US | 131 E CREST RD, HUEYTOWN, AL, 350231623, US | |||||||||||||||
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| Phone | +1 334-749-1969 |
| Phone | +1 334-462-5868 |
Authorized person
| Name | MR. MATTHEW JOSHUA LEWIS |
| Role | OWNER/ADMINISTRATOR |
| Phone | 3344625868 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SELF SKILLED NURSING, LLC 401(K) RETIREMENT PLAN | 2023 | 320133776 | 2024-07-30 | SELF SKILLED NURSING, LLC | 43 | |||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-30 |
| Name of individual signing | MATTHEW LEWIS |
| Role | Employer/plan sponsor |
| Date | 2024-07-30 |
| Name of individual signing | MATTHEW LEWIS |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1994-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 2054912411 |
| Plan sponsor’s address | 131 CREST ROAD, HUEYTOWN, AL, 350231506 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-18 |
| Name of individual signing | MATTHEW LEWIS |
| Role | Employer/plan sponsor |
| Date | 2023-09-18 |
| Name of individual signing | MATTHEW LEWIS |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1994-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 2054912411 |
| Plan sponsor’s address | 131 CREST ROAD, HUEYTOWN, AL, 350231506 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-13 |
| Name of individual signing | MATTHEW LEWIS |
| Name | Role |
|---|---|
| Traylor, Mark | Agent |
| Name | Role | Address |
|---|---|---|
| WEBSTER, J. LANCE | Organizer | 1130 22ND STREET SOUTH, STE. 4000BIRMINGHAM, AL 35205 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
