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  5. CONNECTICUT ADDICTION MEDICINE, LLC

CONNECTICUT ADDICTION MEDICINE, LLC

Company Details

Entity Name: CONNECTICUT ADDICTION MEDICINE, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report past due
Date Formed: 14 Aug 2013
Business ALEI: 1116305
Annual report due: 31 Mar 2024
NAICS code: 621112 - Offices of Physicians, Mental Health Specialists
Business address: 546 CROMWELL AVENUE, ROCKY HILL, CT, 06067, United States
Mailing address: 546 CROMWELL AVENUE, Suite 101, ROCKY HILL, CT, United States, 06067
ZIP code: 06067
County: Hartford
Place of Formation: CONNECTICUT
E-Mail: practicemanager@ctaddictionmedicine.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CONNECTICUT ADDICTION MEDICINE, LLC 401(K) PLAN 2023 463534978 2024-10-15 CONNECTICUT ADDICTION MEDICINE, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106
CONNECTICUT ADDICTION MEDICINE, LLC 401(K) PLAN 2022 463534978 2023-10-16 CONNECTICUT ADDICTION MEDICINE, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106
CONNECTICUT ADDICTION MEDICINE, LLC 401(K) PLAN 2021 463534978 2022-10-14 CONNECTICUT ADDICTION MEDICINE, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106
CONNECTICUT ADDICTION MEDICINE, LLC 401(K) PLAN 2020 463534978 2021-09-08 CONNECTICUT ADDICTION MEDICINE, LLC 26
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106

Signature of
Role Plan administrator
Date 2021-09-07
Name of individual signing MAHBOOB ASLAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-07
Name of individual signing MAHBOOB ASLAM
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT ADDICTION MEDICINE, LLC 401(K) PLAN 2020 463534978 2021-09-10 CONNECTICUT ADDICTION MEDICINE, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106

Signature of
Role Plan administrator
Date 2021-09-10
Name of individual signing MAHBOOB ASLAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-10
Name of individual signing MAHBOOB ASLAM
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT ADDICTION MEDICINE, LLC 401(K) PLAN 2019 463534978 2020-10-12 CONNECTICUT ADDICTION MEDICINE, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106

Signature of
Role Plan administrator
Date 2020-10-11
Name of individual signing MAHBOOB ASLAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-11
Name of individual signing MAHBOOB ASLAM
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT ADDICTION MEDICINE, LLC 2018 463534978 2020-06-16 CONNECTICUT ADDICTION MEDICINE, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106

Signature of
Role Plan administrator
Date 2020-06-16
Name of individual signing LASHAN BROWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-16
Name of individual signing LASHAN BROWN
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT ADDICTION MEDICINE, LLC 2018 463534978 2019-10-14 CONNECTICUT ADDICTION MEDICINE, LLC 19
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621420
Sponsor’s telephone number 8609691101
Plan sponsor’s address 330 MAIN ST., SUITE 101, HARTFORD, CT, 06106

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing LASHAN BROWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-14
Name of individual signing LASHAN BROWN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
THOMAS J. O'NEILL, III, LLC Agent

Officer

Name Role Business address Residence address
JAY BENSON M.D. Officer 178 RIVERKNOLLS, AVON, CT, 06001, United States 178 RIVERKNOLLS, AVON, CT, 06001, United States
MAHBOOB ASLAM M.D. Officer 303 Mercer Lane, Windsor, CT, 06095, United States 303 Mercer Lane, Windsor, CT, 06095, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CLAB.0000910 Clinical Laboratory ACTIVE CURRENT 2018-02-15 2024-04-01 2026-03-31

History

Type Old value New value Date of change
Name change ROCKY HILL BEHAVIORAL HEALTH & ADDICTION MEDICINE, LLC CONNECTICUT ADDICTION MEDICINE, LLC 2015-01-22

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0010826396 2023-06-23 No data Annual Report Annual Report No data
BF-0011316254 2023-06-23 No data Annual Report Annual Report No data
BF-0009251367 2022-12-28 No data Annual Report Annual Report 2019
BF-0009251368 2022-12-28 No data Annual Report Annual Report 2020
BF-0009948005 2022-12-28 No data Annual Report Annual Report No data
BF-0009251366 2022-06-22 No data Annual Report Annual Report 2018
0005899970 2017-08-01 No data Annual Report Annual Report 2017
0005658784 2016-09-27 No data Annual Report Annual Report 2014
0005658787 2016-09-27 No data Annual Report Annual Report 2016
0005658785 2016-09-27 No data Annual Report Annual Report 2015

Related by officers

MAHBOOB ASLAM M.D.

WINDSOR PSYCHIATRIC SERVICES, PLLC

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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