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  5. Central Minnesota Mental Health Center

Central Minnesota Mental Health Center

Company Details

Name: Central Minnesota Mental Health Center
Jurisdiction: Minnesota
Legal type: Nonprofit Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 03 Oct 1963 (61 years ago)
Company Number: 74abfefe-b1d4-e011-a886-001ec94ffe7f
File Number: E-880
Registered Office Address: 1321 13th Str N, St Cloud, MN 56303, USA
ZIP code: 56303
County: Stearns County
Place of Formation: Minnesota

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
VSWXN9CKP3U5 2025-02-15 1321 13TH ST N # C, SAINT CLOUD, MN, 56303, 2613, USA 411 3RD STREET NORTH, WAITE PARK, MN, 56387, USA

Business Information
URL www.cmmhc.org
Division Name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Congressional District 06
State/Country of Incorporation MN, USA
Activation Date 2024-03-06
Initial Registration Date 2015-02-11
Entity Start Date 1963-10-03
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621420

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JESSICA BRANDON
Role EXECUTIVE DIRECTOR
Address 411 3RD STREET N, WAITE PARK, MN, 56387, USA
Government Business
Title PRIMARY POC
Name JESSICA BRANDON
Role EXECUTIVE DIRECTOR
Address 411 3RD STREET N, WAITE PARK, MN, 56387, USA
Past Performance
Title PRIMARY POC
Name DEBORAH LAVALLE
Role ACCOUNTING MANAGER
Address 411 3RD ST N, SUITE 101, WAITE PARK, MN, 56387, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CMMHC HEALTH PLAN 2011 410873142 2012-10-03 CENTRAL MINNESOTA MENTAL HEALTH CENTER 131
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1999-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 129
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC DENTAL, LIFE AND LONG-TERM DISABILITY PLANS 2011 410873142 2012-10-03 CENTRAL MINNESOTA MENTAL HEALTH CENTER 176
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 176
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC DENTAL, LIFE & LONG-TERM DISABILITY PLANS 2010 410873142 2011-10-19 CENTRAL MINNESOTA MENTAL HEALTH CENTER 170
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 169
Retired or separated participants receiving benefits 1

Signature of
Role Plan administrator
Date 2011-10-19
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC DENTAL, LIFE & LONG-TERM DISABILITY PLANS 2010 410873142 2011-10-19 CENTRAL MINNESOTA MENTAL HEALTH CENTER 170
Three-digit plan number (PN) 503
Effective date of plan 2009-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 169
Retired or separated participants receiving benefits 1

Signature of
Role Plan administrator
Date 2011-10-19
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC DENTAL, LIFE & LONG-TERM DISABILITY PLANS 2010 410873142 2011-10-17 CENTRAL MINNESOTA MENTAL HEALTH CENTER 170
Three-digit plan number (PN) 503
Effective date of plan 2009-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 169
Retired or separated participants receiving benefits 1

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC HEALTH INSURANCE PLAN 2010 410873142 2011-08-01 CENTRAL MINNESOTA MENTAL HEALTH CENTER 132
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1999-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 130
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2011-08-01
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC DENTAL, LIFE AND LONG-TERM DISABILITY PLANS 2010 410873142 2011-08-01 CENTRAL MINNESOTA MENTAL HEALTH CENTER 170
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 177

Signature of
Role Plan administrator
Date 2011-08-01
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature
CMMHC HEALTH INSURANCE 2009 410873142 2010-10-14 CENTRAL MINNESOTA MENTAL HEALTH CENTER 132
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1999-01-01
Business code 921000
Sponsor’s telephone number 3202525010
Plan sponsor’s mailing address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Plan sponsor’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303

Plan administrator’s name and address
Administrator’s EIN 410873142
Plan administrator’s name CENTRAL MINNESOTA MENTAL HEALTH CENTER
Plan administrator’s address 1321 13TH STREET NORTH, SAINT CLOUD, MN, 56303
Administrator’s telephone number 3202525010

Number of participants as of the end of the plan year
Active participants 130
Retired or separated participants receiving benefits 2

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing RANDALL BURTZEL
Valid signature Filed with authorized/valid electronic signature

President

Name Role Address
Lisa Fobbe President 909 FAIRWAY DR, PRINCETON, MN 55371–2244, USA

Filing

Filing Name Filing date
Amendment - Nonprofit Corporation (Domestic)Restated Articles 2017-10-09
Merger - Nonprofit Corporation (Domestic) 2009-01-12
Annual Reinstatement - Nonprofit Corporation (Domestic) 2007-02-26
Involuntary Dissolution - Nonprofit Corporation (Domestic) 2006-01-26
Registered Office and/or Agent - Nonprofit Corporation (Domestic) 1990-02-09
Original Filing - Nonprofit Corporation (Domestic) 1963-10-03
Nonprofit Corporation (Domestic) Business Name (Business Name: Central Minnesota Mental Health Center) 1963-10-03

Related by officers

Lisa Fobbe

Fairway Ponds Townhomes, Inc.

Related by address

1321 13th Str N, St Cloud, MN 56303, USA

Central Minnesota Mental Health Housing Corporation

Date of last update: 24 Sep 2024

Sources: Minnesota's Official State Website

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