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  5. Lakeland Mental Health Center, Inc.

Lakeland Mental Health Center, Inc.

Company Details

Name: Lakeland Mental Health Center, Inc.
Jurisdiction: Minnesota
Legal type: Nonprofit Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 24 Feb 1961 (64 years ago)
Company Number: 376e5e74-9ed4-e011-a886-001ec94ffe7f
File Number: D-775
Registered Office Address: 980 South Tower Road, Fergus Falls, MN 56537, USA
ZIP code: 56537
County: Otter Tail County
Place of Formation: Minnesota

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
JYL2K8BBCRE3 2024-09-13 980 S TOWER RD, FERGUS FALLS, MN, 56537, 5505, USA 980 SOUTH TOWER ROAD, FERGUS FALLS, MN, 56537, 2903, USA

Business Information
Congressional District 07
State/Country of Incorporation MN, USA
Activation Date 2023-09-18
Initial Registration Date 2002-03-11
Entity Start Date 1949-10-01
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name TOM MASLOSKI
Role CFO
Address 980 SOUTH TOWER ROAD, FERGUS FALLS, MN, 56537, USA
Government Business
Title PRIMARY POC
Name TOM MASLOSKI
Role CFO
Address 980 SOUTH TOWER ROAD, FERGUS FALLS, MN, 56537, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKELAND MENTAL HEALTH CENTER HEALTH INSURANCE PLAN 2023 410843966 2024-05-20 LAKELAND MENTAL HEALTH CENTER 122
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2020-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 129

Signature of
Role Plan administrator
Date 2024-05-20
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC GROUP TERM LIFE PLAN 2023 410843966 2024-05-20 LAKELAND MENTAL HEALTH CENTER INC 163
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 163

Signature of
Role Plan administrator
Date 2024-05-20
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC LONG TERM DISABILITY PLAN 2023 410843966 2024-05-20 LAKELAND MENTAL HEALTH CENTER INC. 144
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 149

Signature of
Role Plan administrator
Date 2024-05-20
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC GROUP TERM LIFE PLAN 2022 410843966 2023-05-08 LAKELAND MENTAL HEALTH CENTER INC 156
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 162

Signature of
Role Plan administrator
Date 2023-05-04
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC LONG TERM DISABILITY PLAN 2022 410843966 2023-05-08 LAKELAND MENTAL HEALTH CENTER INC 141
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 144

Signature of
Role Plan administrator
Date 2023-05-04
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER HEALTH INSURANCE PLAN 2022 410843966 2023-05-08 LAKELAND MENTAL HEALTH CENTER INC 125
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2020-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 121

Signature of
Role Plan administrator
Date 2023-05-04
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC LONG TERM DISABILITY PLAN 2021 410843966 2022-05-05 LAKELAND MENTAL HEALTH CENTER INC 142
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 141

Signature of
Role Plan administrator
Date 2022-05-05
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC SHORT TERM DISABILITY PLAN 2021 410843966 2022-05-05 LAKELAND MENTAL HEALTH CENTER INC 96
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 89

Signature of
Role Plan administrator
Date 2022-05-05
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER INC GROUP TERM LIFE PLAN 2021 410843966 2022-05-05 LAKELAND MENTAL HEALTH CENTER INC 159
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2019-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Plan administrator’s name and address
Administrator’s EIN 410843966
Plan administrator’s name LAKELAND MENTAL HEALTH CENTER INC
Plan administrator’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Administrator’s telephone number 2187366987

Number of participants as of the end of the plan year
Active participants 156

Signature of
Role Plan administrator
Date 2022-05-05
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature
LAKELAND MENTAL HEALTH CENTER HEALTH INSURANCE PLAN 2021 410843966 2022-05-05 LAKELAND MENTAL HEALTH CENTER INC 114
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2020-01-01
Business code 621420
Sponsor’s telephone number 2187366987
Plan sponsor’s mailing address 980 S TOWER RD, FERGUS FALLS, MN, 565375505
Plan sponsor’s address 980 S TOWER RD, FERGUS FALLS, MN, 565375505

Number of participants as of the end of the plan year
Active participants 124

Signature of
Role Plan administrator
Date 2022-05-05
Name of individual signing DONNA BAKER
Valid signature Filed with authorized/valid electronic signature

President

Name Role Address
Donna Baker President 980 South Tower Road, Fergus Falls, MN 56537, USA

Filing

Filing Name Filing date
Registered Office - Nonprofit Corporation (Domestic) 2019-03-18
Annual Reinstatement - Nonprofit Corporation (Domestic) 2017-05-19
Involuntary Dissolution - Nonprofit Corporation (Domestic) 2017-02-22
Merger - Nonprofit Corporation (Domestic) 1994-07-28
Registered Office and/or Agent - Nonprofit Corporation (Domestic) 1990-08-03
Amendment - Nonprofit Corporation (Domestic) 1978-06-22
Original Filing - Nonprofit Corporation (Domestic) 1961-02-24
Nonprofit Corporation (Domestic) Business Name (Business Name: Lakeland Mental Health Center, Inc.) 1961-02-24

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Oct 2024

Sources: Minnesota's Official State Website

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