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  5. CRESTWOOD MANOR, LLC

CRESTWOOD MANOR, LLC

Company Details

Entity Name: CRESTWOOD MANOR, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Admin Dissolution Initiated
Date Formed: 24 Sep 2010
Business ALEI: 1016129
Annual report due: 31 Mar 2023
NAICS code: 623990 - Other Residential Care Facilities
Business address: 90 BROAD STREET, NORWICH, CT, 06360, United States
Mailing address: 90 BROAD STREET, NORWICH, CT, United States, 06360
ZIP code: 06360
County: New London
Place of Formation: CONNECTICUT
E-Mail: INFO2@CPS-FILINGS.COM

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CRESTWOOD MANOR LLC 401(K) PROFIT SHARING PLAN & TRUST 2023 273577589 2024-05-15 CRESTWOOD MANOR LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2024-05-15
Name of individual signing DEBRA A DUCH
Valid signature Filed with authorized/valid electronic signature
CRESTWOOD MANOR LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 273577589 2023-06-21 CRESTWOOD MANOR LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2023-06-21
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
CRESTWOOD MANOR LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 273577589 2022-07-06 CRESTWOOD MANOR LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2022-07-06
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
CRESTWOOD MANOR LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 273577589 2021-10-07 CRESTWOOD MANOR LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2021-10-07
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
CRESTWOOD MANOR LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 273577589 2020-07-02 CRESTWOOD MANOR LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2020-07-02
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
CRESTWOOD MANOR LLC 401 K PROFIT SHARING PLAN TRUST 2018 273577589 2019-05-23 CRESTWOOD MANOR LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Plan administrator’s name and address
Administrator’s EIN 264477125
Plan administrator’s name 401K GENERATION
Plan administrator’s address 195 INTERNATIONAL PKWY, S #311, LAKE MARY, FL, 32746
Administrator’s telephone number 8669985879

Signature of
Role Plan administrator
Date 2019-05-23
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
CRESTWOOD MANOR LLC 401 K PROFIT SHARING PLAN TRUST 2017 273577589 2018-04-11 CRESTWOOD MANOR LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 8608898800
Plan sponsor’s address 90 BROAD STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2018-04-11
Name of individual signing DEBRA DUCH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
DEBRA A. DUCH Agent 90 BROAD STREET, NORWICH, CT, 06360, United States 90 BROAD STREET, NORWICH, CT, 06360, United States +1 860-889-8800 crestcooodmanor@att.net 489 BROOKLYN RD., CANTERBURY, CT, 06331, United States

Officer

Name Role Business address Phone E-Mail Residence address
DEBRA A. DUCH Officer 90 BROAD STREET, NORWICH, CT, 06360, United States +1 860-889-8800 crestcooodmanor@att.net 489 BROOKLYN RD., CANTERBURY, CT, 06331, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
RCH.1723RCH Residential Care Facility CLOSED CLOSED 2008-01-01 2023-01-01 2025-12-31

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012756067 2024-09-04 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
BF-0010401473 2022-01-15 No data Annual Report Annual Report 2022
0007220712 2021-03-11 No data Annual Report Annual Report 2021
0006781530 2020-02-25 No data Annual Report Annual Report 2020
0006336930 2019-01-25 No data Annual Report Annual Report 2019
0006336920 2019-01-25 No data Annual Report Annual Report 2018
0006021590 2018-01-22 No data Annual Report Annual Report 2017
0005783074 2017-03-06 No data Annual Report Annual Report 2016
0005645044 2016-09-07 No data Annual Report Annual Report 2015
0005166501 2014-08-18 No data Annual Report Annual Report 2014

Related by officers

DEBRA A. DUCH

CRESTWOOD REAL ESTATE, INC.

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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