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  5. MIDDLEBURY CONVALESCENT HOME, INC.

MIDDLEBURY CONVALESCENT HOME, INC.

Company Details

Entity Name: MIDDLEBURY CONVALESCENT HOME, INC.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 22 Jun 1961
Business ALEI: 0081781
Annual report due: 22 Jun 2025
NAICS code: 623110 - Nursing Care Facilities (Skilled Nursing Facilities)
Business address: 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, United States
Mailing address: 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, United States, 06762
ZIP code: 06762
County: New Haven
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: jhammitt@midconvhome.com

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
MVXDECQLZKY6 2024-07-25 778 MIDDLEBURY RD, MIDDLEBURY, CT, 06762, 2401, USA 778 MIDDLEBURY RD, MIDDLEBURY, CT, 06762, 2401, USA

Business Information
Doing Business As MIDDLEBURY CONVALESCENT HOME INC
Congressional District 05
State/Country of Incorporation CT, USA
Activation Date 2023-07-28
Initial Registration Date 2022-07-20
Entity Start Date 1961-05-21
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name CHRISTINE FEOLA
Role ACCOUNTS RECEIVABLE
Address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, USA
Government Business
Title PRIMARY POC
Name JEANINE HAMMITT
Role ADMINISTRATOR
Address 778 MIDDLEBURY RD, MIDDLEBURY, CT, 06762, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MIDDLEBURY CONVALESCENT HOME, INC 2023 060769641 2024-07-26 MIDDLEBURY CONVALESCENT HOME, INC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2023 060769641 2024-07-08 MIDDLEBURY CONVALESCENT HOME, INC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2022 060769641 2023-09-12 MIDDLEBURY CONVALESCENT HOME, INC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2021 060769641 2022-10-03 MIDDLEBURY CONVALESCENT HOME, INC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2020 060769641 2021-05-27 MIDDLEBURY CONVALESCENT HOME, INC 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2019 060769641 2020-06-17 MIDDLEBURY CONVALESCENT HOME, INC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2018 060769641 2019-09-26 MIDDLEBURY CONVALESCENT HOME, INC 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2017 060769641 2018-10-04 MIDDLEBURY CONVALESCENT HOME, INC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2016 060769641 2017-07-05 MIDDLEBURY CONVALESCENT HOME, INC 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762

Signature of
Role Plan administrator
Date 2017-07-05
Name of individual signing JEANINE HAMMITT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-05
Name of individual signing JEANINE HAMMITT
Valid signature Filed with authorized/valid electronic signature
MIDDLEBURY CONVALESCENT HOME, INC 401(K) PROFIT SHARING PLAN 2015 060769641 2016-05-16 MIDDLEBURY CONVALESCENT HOME, INC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 2037582471
Plan sponsor’s address 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762

Signature of
Role Plan administrator
Date 2016-05-16
Name of individual signing SHERRY GIANDO FOSTER
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Phone E-Mail Residence address
CYNTHIA FASSETT RESHA Officer 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, United States No data No data 194 BEACON VALLEY ROAD, BEACON FALLS, CT, 06403, United States
JEANINE HAMMITT Officer 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, United States +1 203-917-1879 jhammitt@midconvhome.com 24 QUANOPAUG TRAIL, WOODBURY, CT, 06798, United States
ELAINE DABBO Officer 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, United States No data No data 232 SCUPPO ROAD, WOODBURY, CT, 06798, United States

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
JEANINE HAMMITT Agent 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, United States 778 MIDDLEBURY ROAD, MIDDLEBURY, CT, 06762, United States +1 203-917-1879 jhammitt@midconvhome.com 24 QUANOPAUG TRAIL, WOODBURY, CT, 06798, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CCNH.000704C Chronic & Convalescent Nursing Home CLOSED CLOSED 2008-04-01 2022-04-01 2024-03-31

History

Type Old value New value Date of change
Name change MIDDLEBURY CONVALESCENT HOSPITAL, INC. MIDDLEBURY CONVALESCENT HOME, INC. 1973-07-25
Name change MIDDLEBURY CONVALESCENT HOME, INC. MIDDLEBURY CONVALESCENT HOSPITAL, INC. 1964-05-15

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012048860 2024-06-21 No data Annual Report Annual Report No data
BF-0011077968 2023-06-15 No data Annual Report Annual Report No data
BF-0010250389 2022-06-02 No data Annual Report Annual Report 2022
0007329105 2021-05-10 No data Annual Report Annual Report 2021
0006903979 2020-05-13 No data Annual Report Annual Report 2017
0006903986 2020-05-13 No data Annual Report Annual Report 2019
0006903985 2020-05-13 No data Annual Report Annual Report 2018
0006903989 2020-05-13 No data Annual Report Annual Report 2020
0005859369 2017-06-06 No data Annual Report Annual Report 2016
0005859361 2017-06-06 No data Annual Report Annual Report 2015

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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