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  5. Lewiston Villa Nursing Home

Lewiston Villa Nursing Home

Company Details

Name: Lewiston Villa Nursing Home
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Inactive
Date formed: 12 Jan 1984 (41 years ago)
Company Number: 77b94316-abd4-e011-a886-001ec94ffe7f
File Number: 32510
Principal Place of Business Address: 505 E Main St, Lewiston, MN 55952, USA
ZIP code: 55952
County: Winona County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LEWISTON VILLA NURSING HOME RETIREMENT SAVINGS PLAN 2012 411451927 2013-03-28 LEWISTON VILLA NURSING HOME 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 5075232123
Plan sponsor’s address 505 E MAIN STREET, LEWISTON, MN, 559521204

Plan administrator’s name and address
Administrator’s EIN 411451927
Plan administrator’s name LEWISTON VILLA NURSING HOME
Plan administrator’s address 505 E MAIN STREET, LEWISTON, MN, 559521204
Administrator’s telephone number 5075232123

Signature of
Role Plan administrator
Date 2013-03-28
Name of individual signing ROBERT W LIEBIG
Valid signature Filed with authorized/valid electronic signature
LEWISTON VILLA NURSING HOME RETIREMENT SAVINGS PLAN 2012 411451927 2013-12-31 LEWISTON VILLA NURSING HOME 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 5075232123
Plan sponsor’s address 505 E MAIN STREET, LEWISTON, MN, 559521204

Plan administrator’s name and address
Administrator’s EIN 411451927
Plan administrator’s name LEWISTON VILLA NURSING HOME
Plan administrator’s address 505 E MAIN STREET, LEWISTON, MN, 559521204
Administrator’s telephone number 5075232123

Signature of
Role Plan administrator
Date 2013-12-31
Name of individual signing ROBERT W LIEBIG
Valid signature Filed with authorized/valid electronic signature
LEWISTON VILLA NURSING HOME RETIREMENT SAVINGS PLAN 2011 411451927 2012-04-03 LEWISTON VILLA NURSING HOME 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 5075232123
Plan sponsor’s address 505 E MAIN STREET, LEWISTON, MN, 559521204

Plan administrator’s name and address
Administrator’s EIN 411451927
Plan administrator’s name LEWISTON VILLA NURSING HOME
Plan administrator’s address 505 E MAIN STREET, LEWISTON, MN, 559521204
Administrator’s telephone number 5075232123

Signature of
Role Plan administrator
Date 2012-04-03
Name of individual signing ROBERT W LIEBIG
Valid signature Filed with authorized/valid electronic signature
LEWISTON VILLA NURSING HOME RETIREMENT SAVINGS PLAN 2010 411451927 2011-04-21 LEWISTON VILLA NURSING HOME 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 5075232123
Plan sponsor’s address 505 E MAIN STREET, LEWISTON, MN, 559521204

Plan administrator’s name and address
Administrator’s EIN 411451927
Plan administrator’s name LEWISTON VILLA NURSING HOME
Plan administrator’s address 505 E MAIN STREET, LEWISTON, MN, 559521204
Administrator’s telephone number 5075232123

Signature of
Role Plan administrator
Date 2011-04-21
Name of individual signing ROBERT W LIEBIG
Valid signature Filed with authorized/valid electronic signature
LEWISTON VILLA NURSING HOME RETIREMENT SAVINGS PLAN 2009 411451927 2010-09-28 LEWISTON VILLA NURSING HOME 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 5075232123
Plan sponsor’s address 505 E MAIN STREET, LEWISTON, MN, 559521204

Plan administrator’s name and address
Administrator’s EIN 411451927
Plan administrator’s name LEWISTON VILLA NURSING HOME
Plan administrator’s address 505 E MAIN STREET, LEWISTON, MN, 559521204
Administrator’s telephone number 5075232123

Signature of
Role Plan administrator
Date 2010-09-28
Name of individual signing ROBERT W LIEBIG
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Bob Liebig Aplicant 6 Hill Farm Circ, North Oaks, MN 55127
Deloughery Home LP Aplicant 1200 S Waldron Rd #155, Fort Smith, AR 72903

Filing

Filing Name Filing date
Expired - Assumed Name 2014-01-13
Assumed Name Renewal 1993-09-01
Assumed Name Nameholder 1992-05-06
Original Filing - Assumed Name 1984-01-12
Assumed Name Business Name (Business Name: Lewiston Villa Nursing Home) 1984-01-12

Related by officers

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Date of last update: 02 Oct 2024

Sources: Minnesota's Official State Website

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