| Entity Name: | THE JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Non-Stock |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 14 Aug 1967 |
| Business ALEI: | 0062194 |
| Annual report due: | 14 Aug 2025 |
| NAICS code: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Business address: | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, United States |
| Mailing address: | 4200 PARK AVENUE, BRIDGEPORT, CT, United States, 06604 |
| ZIP code: | 06604 |
| County: | Fairfield |
| Place of Formation: | CONNECTICUT |
| E-Mail: | epeterson@mozaicsl.org |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| XPNJMPKUULL3 | 2025-02-12 | 4200 PARK AVE, BRIDGEPORT, CT, 06604, 1049, USA | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, 1049, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 04 |
| State/Country of Incorporation | CT, USA |
| Activation Date | 2024-02-15 |
| Initial Registration Date | 2008-03-11 |
| Entity Start Date | 1973-10-15 |
| Fiscal Year End Close Date | Sep 30 |
Service Classifications
| NAICS Codes | 623110 |
| Product and Service Codes | Q402 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | EVANGELYN PETERSON |
| Address | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, USA |
| Title | ALTERNATE POC |
| Name | LAURA SNOW |
| Address | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | LAURA SNOW-ROBINSON |
| Address | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, USA |
| Title | ALTERNATE POC |
| Name | LAURA SNOW-ROBINSON |
| Address | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, USA |
| Past Performance | Information not Available |
|---|
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 50NH0 | Active | Non-Manufacturer | 2008-03-12 | 2024-03-08 | 2029-02-15 | 2025-02-12 | |||||||||||||||
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| POC | LAURA SNOW-ROBINSON |
| Phone | +1 203-365-6403 |
| Fax | +1 203-374-4851 |
| Address | 4200 PARK AVE, BRIDGEPORT, CT, 06604 1049, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 549300WXCETU0B7T4152 | 0062194 | US-CT | GENERAL | ACTIVE | 1967-08-14 | |||||||||||||||||||
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| Legal | C/O ANDREW H. BANOFF, 4200 PARK AVENUE, BRIDGEPORT, US-CT, US, 06604 |
| Headquarters | C/O ANDREW H. BANOFF, 4200 PARK AVENUE, BRIDGEPORT, US-CT, US, 06604 |
Registration details
| Registration Date | 2014-04-29 |
| Last Update | 2023-08-04 |
| Status | LAPSED |
| Next Renewal | 2023-06-01 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | 0062194 |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| ANDREW H. BANOFF | Agent | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, United States | +1 203-365-6400 | epeterson@mozaicsl.org | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| ANDREW H.BANOFF | Officer | 4200 PARK AVE, BRIDGEPORT, CT, 06604, United States | 4200 PARK AVE, BRIDGEPORT, CT, 06604, United States |
| Emil Meshberg | Officer | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, United States | 4200 PARK AVENUE, BRIDGEPORT, CT, 06604, United States |
| JON AUGUST | Officer | 4200 PARK AVE, BRIDGEPORT, CT, 06604, United States | 4200 PARK AVE, BRIDGEPORT, CT, 06604, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| LTA.0004355 | TEMPORARY LIQUOR | INACTIVE | No data | No data | 2022-10-13 | 2022-10-13 |
| LCO.0010730 | TEMPORARY CHARITABLE ORGANIZATION LIQUOR | INACTIVE | No data | No data | 2023-05-01 | 2023-05-01 |
| LTN.0000238 | TEMPORARY NONCOMMERCIAL LIQUOR PERMIT | INACTIVE | No data | No data | 2023-10-26 | 2023-10-26 |
| LTN.0001395 | TEMPORARY NONCOMMERCIAL LIQUOR PERMIT | ACTIVE | CURRENT | No data | 2024-10-30 | 2024-10-30 |
| CCNH.000923C | Chronic & Convalescent Nursing Home | CLOSED | CLOSED | 2008-04-01 | 2016-04-01 | 2018-03-31 |
| Type | Old value | New value | Date of change |
|---|---|---|---|
| Name change | JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY, INCORPORATED THE | THE JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY, INC. | 2014-02-24 |
| Name change | THE JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY, INC. | THE JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY, INC. | 2014-02-21 |
| Name change | FAIRFIELD COUNTY HOME FOR THE ELDERLY, INCORPORATED THE | JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY, INCORPORATED THE | 1970-01-08 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012043691 | 2024-07-15 | No data | Annual Report | Annual Report | No data |
| BF-0011077615 | 2023-07-25 | No data | Annual Report | Annual Report | No data |
| BF-0010252211 | 2022-08-03 | No data | Annual Report | Annual Report | 2022 |
| BF-0009810339 | 2021-09-30 | No data | Annual Report | Annual Report | No data |
| 0007006368 | 2020-10-21 | No data | Annual Report | Annual Report | 2020 |
| 0006593155 | 2019-07-09 | No data | Annual Report | Annual Report | 2019 |
| 0006221880 | 2018-07-25 | No data | Annual Report | Annual Report | 2018 |
| 0005930870 | 2017-09-20 | No data | Annual Report | Annual Report | 2017 |
| 0005650405 | 2016-09-13 | No data | Change of Business Address | Business Address Change | No data |
| 0005637329 | 2016-08-25 | No data | Change of Agent Address | Agent Address Change | No data |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No data | IDV | 36C24124D0052 | 2024-01-15 | No data | No data | |||||||||||||||||||||||||
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| Obligated Amount | 0.00 |
| Potential Award Amount | 1840847.36 |
Description
| Title | NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INC |
| UEI | XPNJMPKUULL3 |
| Recipient Address | UNITED STATES, 4200 PARK AVENUE, BRIDGEPORT, FAIRFIELD, CONNECTICUT, 066041049 |
| Unique Award Key | CONT_AWD_36C24124K0152_3600_36C24124D0052_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 228460.35 |
| Current Award Amount | 228460.35 |
| Potential Award Amount | 228460.35 |
Description
| Title | EXPRESS REPORT: NURSING HOME CARE |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INC |
| UEI | XPNJMPKUULL3 |
| Recipient Address | UNITED STATES, 4200 PARK AVENUE, BRIDGEPORT, GREATER BRIDGEPORT, CONNECTICUT, 066041049 |
| Unique Award Key | CONT_AWD_36C24124K0061_3600_36C24120G0028_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 47905.00 |
| Current Award Amount | 47905.00 |
| Potential Award Amount | 47905.00 |
Description
| Title | EXPRESS REPORT: CNH |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INC |
| UEI | XPNJMPKUULL3 |
| Recipient Address | UNITED STATES, 4200 PARK AVENUE, BRIDGEPORT, FAIRFIELD, CONNECTICUT, 066041049 |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
