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NATCHAUG HOSPITAL, INC.

Company Details

Entity Name: NATCHAUG HOSPITAL, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 22 Dec 1976
Business ALEI: 0062284
Annual report due: 22 Dec 2024
NAICS code: 622110 - General Medical and Surgical Hospitals
Business address: 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250, United States
Mailing address: 189 STORRS ROAD, MANSFIELD CENTER, CT, United States, 06250
ZIP code: 06250
County: Tolland
Place of Formation: CONNECTICUT
E-Mail: legal.support@hhchealth.org

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
QRTYGQW58JB8 2024-07-04 189 STORRS RD, MANSFIELD CENTER, CT, 06250, 1683, USA 181 PATRICIA M GENOVA DR, TREASURY SERVICES 4TH FLOOR, NEWINGTON, CT, 06111, USA

Business Information

Doing Business As NATCHAUG HOSPITAL
Congressional District 02
State/Country of Incorporation CT, USA
Activation Date 2023-07-07
Initial Registration Date 2019-03-12
Entity Start Date 1976-12-22
Fiscal Year End Close Date Sep 30

Points of Contacts

Electronic Business
Title PRIMARY POC
Name SHANAN HARKNESS
Address 181 PATRICIA M GENOVA DRIVE, NEWINGTON, CT, 06111, USA
Government Business
Title PRIMARY POC
Name SHANAN HARKNESS
Address 181 PATRICIA M GENOVA DRIVE, NEWINGTON, CT, 06111, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2014 060966963 2016-01-25 NATCHAUG HOSPITAL, INC. 668
File View Page
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8606963295
Plan sponsor’s mailing address 181 PATRICIA M. GENOVA DRIVE, NEWINGTON, CT, 061111500
Plan sponsor’s address 181 PATRICIA M. GENOVA DRIVE, NEWINGTON, CT, 061111500

Number of participants as of the end of the plan year

Active participants 351
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 82
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 433
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 11
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2014 060966963 2015-10-15 NATCHAUG HOSPITAL, INC. 668
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8606963295
Plan sponsor’s mailing address 181 PATRICIA M. GENOVA DRIVE, NEWINGTON, CT, 061111500
Plan sponsor’s address 181 PATRICIA M. GENOVA DRIVE, NEWINGTON, CT, 061111500

Number of participants as of the end of the plan year

Active participants 351
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 82
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 433
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 11
NATCHAUG HOSPITAL PENSION PLAN FOR HOSPITAL AND HEALTH CARE EMPLOYEES 2014 060966963 2015-05-14 NATCHAUG HOSPITAL, INC. 217
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1983-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250
Plan sponsor’s address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250

Number of participants as of the end of the plan year

Active participants 155
Retired or separated participants receiving benefits 21
Other retired or separated participants entitled to future benefits 60
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 6

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2014 060966963 2015-05-14 NATCHAUG HOSPITAL, INC 359
File View Page
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 06250
Plan sponsor’s address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 06250

Number of participants as of the end of the plan year

Active participants 286
Retired or separated participants receiving benefits 4
Other retired or separated participants entitled to future benefits 137
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 417
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL AMENDED & RESTATED PENSION PLAN FOR HOSPITAL AND HEALTH CARE EMPLOYEES 2014 060966963 2015-05-14 NATCHAUG HOSPITAL, INC 237
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1983-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250
Plan sponsor’s address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250

Number of participants as of the end of the plan year

Active participants 165
Retired or separated participants receiving benefits 22
Other retired or separated participants entitled to future benefits 67
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 9

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2014 060966963 2015-05-14 NATCHAUG HOSPITAL, INC 558
File View Page
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 062501683
Plan sponsor’s address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 062501683

Number of participants as of the end of the plan year

Active participants 296
Other retired or separated participants entitled to future benefits 278
Number of participants with account balances as of the end of the plan year 541
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 21

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL AMENDED & RESTATED PENSION PLAN FOR HOSPITAL AND HEALTH CARE EMPLOYEES 2014 060966963 2015-05-14 NATCHAUG HOSPITAL, INC. 254
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1983-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250
Plan sponsor’s address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address

Administrator’s EIN 060966963
Plan administrator’s name NATCHAUG HOSPITAL, INC.
Plan administrator’s address 189 STORRS ROAD, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604561311

Number of participants as of the end of the plan year

Active participants 164
Retired or separated participants receiving benefits 24
Other retired or separated participants entitled to future benefits 75
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 3

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2014 060966963 2015-05-14 NATCHAUG HOSPITAL, INC 436
File View Page
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 06250
Plan sponsor’s address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 06250

Number of participants as of the end of the plan year

Active participants 291
Other retired or separated participants entitled to future benefits 262
Number of participants with account balances as of the end of the plan year 515
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 26

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2013 060966963 2015-05-14 NATCHAUG HOSPITAL, INC. 607
File View Page
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, MANSFIELD CENTER, CT, 062501683
Plan sponsor’s address 189 STORRS ROAD, MANSFIELD CENTER, CT, 062501683

Number of participants as of the end of the plan year

Active participants 293
Other retired or separated participants entitled to future benefits 361
Number of participants with account balances as of the end of the plan year 599

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature
NATCHAUG HOSPITAL, INC. RETIREMENT PLAN 2012 060966963 2015-05-14 NATCHAUG HOSPITAL, INC 622
File View Page
Three-digit plan number (PN) 005
Effective date of plan 1995-10-01
Business code 622000
Sponsor’s telephone number 8604561311
Plan sponsor’s mailing address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 062501683
Plan sponsor’s address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 062501683

Plan administrator’s name and address

Administrator’s EIN 060966963
Plan administrator’s name NATCHAUG HOSPITAL, INC
Plan administrator’s address 189 STORRS ROAD, PO BOX 498, MANSFIELD CENTER, CT, 062501683
Administrator’s telephone number 8604561311

Number of participants as of the end of the plan year

Active participants 293
Other retired or separated participants entitled to future benefits 368
Number of participants with account balances as of the end of the plan year 607
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 30

Signature of

Role Plan administrator
Date 2015-05-14
Name of individual signing MARK LAPIERRE
Valid signature Filed with authorized/valid electronic signature

Director

Name Role Business address Residence address
DONNA HANDLEY Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE, WILLIMANTIC, CT, 06226, United States
STEPHEN W. LARCEN PH.D. Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States
Lee-Ann Gomes Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE., WILLIMANTIC, CT, 06226, United States
Joanna Chaurette Director 100 Pearl St., 2nd Fl., CLO, Hartford, CT, 06103, United States 100 Pearl St., 2nd Fl., CLO, Hartford, CT, 06103, United States
ANTHONY A. JOYCE III Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE., WILLIMANTIC, CT, 06226, United States
HENRY BECK ESQ. Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States
MARY E. BARRY MD Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE., WILLIMANTIC, CT, 06226, United States
MARK TRAMONTOZZI MD Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE, WILLIMANTIC, WILLIMANTIC, CT, 06226, United States
Anita Lee Director 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE., WILLIMANTIC, CT, 06226, United States

Officer

Name Role Business address Residence address
James O'Dea Officer 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 883 PADDOCK AVENUE, MERIDEN, CT, 06450, United States
DAVID MACK ESQ. Officer 100 Pearl St., 2nd Floor, CLO, Hartford, CT, 06103, United States 883 PADDOCK AVENUE, MERIDEN, CT, 06450, United States
HENRY BECK ESQ. Officer 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States
MARY E. BARRY MD Officer 100 Pearl St., 2nd Floor, Hartford, CT, 06103, United States 112 MANSFIELD AVE., WILLIMANTIC, CT, 06226, United States

Agent

Name Role
UNITED STATES CORPORATION COMPANY Agent

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CHR.0006162-EXEMPT PUBLIC CHARITY-EXEMPT FROM FINANCIAL REQUIREMENTS ACTIVE No data No data No data No data
PSY.00H0003 Hospitals for Mentally Ill Persons ACTIVE CURRENT 2009-07-01 2023-07-01 2025-06-30
CSP.0006434-HOSP CONTROLLED SUBSTANCE REGISTRATION FOR HOSPITALS ACTIVE CURRENT 1999-03-08 2023-03-01 2025-02-28

History

Type Old value New value Date of change
Name change NATCHAUG HOSPITAL OUT-PATIENT MENTAL HEALTH SERVICES, INC. NATCHAUG HOSPITAL, INC. 1977-05-31

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012582992 2024-03-13 2024-03-13 Amendment Certificate of Amendment No data
BF-0011077858 2023-12-04 No data Annual Report Annual Report No data
BF-0010194490 2022-12-05 No data Annual Report Annual Report 2022
BF-0010470496 2022-01-14 2022-01-14 Mass Agent Change � Address Agent Address Change No data
BF-0009828724 2021-12-06 No data Annual Report Annual Report No data
0007016441 2020-11-11 No data Annual Report Annual Report 2019
0007016452 2020-11-11 No data Annual Report Annual Report 2020
0006950703 2020-07-06 2020-07-06 Change of Agent Address Agent Address Change No data
0006943532 2020-07-06 2020-07-06 Change of Agent Address Agent Address Change No data
0006854555 2020-03-30 2020-03-30 Change of Agent Agent Change No data

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website