| Entity Name: | SUPPORTIVE ENVIRONMENTAL LIVING FACILITY, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Non-Stock |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 13 Apr 1988 |
| Business ALEI: | 0215022 |
| Annual report due: | 13 Apr 2025 |
| NAICS code: | 623220 - Residential Mental Health and Substance Abuse Facilities |
| Business address: | 47 PIERPONT ST, WATERBURY, CT, 06708, United States |
| Mailing address: | 47 PIERPONT ST, WATERBURY, CT, United States, 06708 |
| ZIP code: | 06708 |
| County: | New Haven |
| Place of Formation: | CONNECTICUT |
| E-Mail: | ktaglia@selfct.org |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| GINA M. PETROKAITIS | Agent | 678 CHASE PARKWAY, WATERBURY, CT, 06708, United States | +1 203-592-3360 | ktaglia@selfct.org | 3 MAYFIELD RD, WATERBURY, CT, 06708, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| GINA PETROKAITIS | Officer | No data | 3 MAYFIELD RD., WATERBURY, CT, 06708, United States |
| KIMBERLEY TAGLIA | Officer | 47 PIERPONT ST, WATERBURY, CT, 06708, United States | 12 SPINDLE HILL RD 10F, WOLCOTT, CT, 06716, United States |
| LINDA NORMAN | Officer | 47 PIERPONT ST, WATERBURY, CT, 06708, United States | 181 LOOMIS DR. #123, WEST HARTFORD, CT, 06107, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| MHRL.0000051 | Mental Health Residential Living | CLOSED | CLOSED | 2016-03-30 | 2016-03-30 | 2017-12-31 |
| CHR.0059419-EXEMPT | PUBLIC CHARITY-EXEMPT FROM FINANCIAL REQUIREMENTS | ACTIVE | CURRENT | 2016-02-01 | 2016-02-01 | No data |
| Type | Old value | New value | Date of change |
|---|---|---|---|
| Name change | SELF, INC. | SUPPORTIVE ENVIRONMENTAL LIVING FACILITY, INC. | 1989-06-26 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012189399 | 2024-03-19 | No data | Annual Report | Annual Report | No data |
| BF-0011387440 | 2023-03-16 | No data | Annual Report | Annual Report | No data |
| BF-0010293589 | 2022-04-12 | No data | Annual Report | Annual Report | 2022 |
| 0007298833 | 2021-04-14 | No data | Annual Report | Annual Report | 2021 |
| 0006879209 | 2020-04-08 | No data | Annual Report | Annual Report | 2020 |
| 0006581252 | 2019-06-20 | No data | Annual Report | Annual Report | 2018 |
| 0006581265 | 2019-06-20 | No data | Annual Report | Annual Report | 2019 |
| 0006516176 | 2019-03-15 | 2019-03-15 | Change of Agent | Agent Change | No data |
| 0005821644 | 2017-04-19 | No data | Annual Report | Annual Report | 2017 |
| 0005563799 | 2016-05-16 | No data | Annual Report | Annual Report | 2016 |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
