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  5. CAPERNAUM PEDIATRIC THERAPY, INC.

CAPERNAUM PEDIATRIC THERAPY, INC.

Company Details

Name: CAPERNAUM PEDIATRIC THERAPY, INC.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 22 Jul 1988 (36 years ago)
Company Number: a123acc1-a9d4-e011-a886-001ec94ffe7f
File Number: 5Z-935
Registered Office Address: 200 E University Avenue, St Paul, MN 55101, USA
Principal Executive Office Address: STE 430, 6625 LYNDALE AVE S, RICHFIELD, MN 55423–2300, USA
ZIP code: 55101
County: Ramsey County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAPERNAUM PEDIATRIC THERAPY 401(K) PROFIT SHARING PLAN TRUST 2023 411618385 2024-06-06 CAPERNAUM PEDIATRIC THERAPY INC. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 6625 LYNDALE AVE S STE 430, RICHFIELD, MN, 55423

Signature of
Role Plan administrator
Date 2024-06-06
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY 401(K) PROFIT SHARING PLAN TRUST 2022 411618385 2023-06-17 CAPERNAUM PEDIATRIC THERAPY INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 6625 LYNDALE AVE S STE 430, RICHFIELD, MN, 55423

Signature of
Role Plan administrator
Date 2023-06-17
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2015 411618385 2016-11-15 CAPERNAUM PEDIATRIC THERAPY, INC 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Signature of
Role Plan administrator
Date 2016-11-15
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-11-15
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2015 411618385 2016-07-19 CAPERNAUM PEDIATRIC THERAPY, INC 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Signature of
Role Plan administrator
Date 2016-07-19
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2014 411618385 2015-07-07 CAPERNAUM PEDIATRIC THERAPY, INC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Signature of
Role Plan administrator
Date 2015-07-07
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-07
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2013 411618385 2014-07-09 CAPERNAUM PEDIATRIC THERAPY, INC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Signature of
Role Plan administrator
Date 2014-07-09
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2012 411618385 2013-07-01 CAPERNAUM PEDIATRIC THERAPY, INC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Signature of
Role Plan administrator
Date 2013-07-01
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-01
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2011 411618385 2012-06-13 CAPERNAUM PEDIATRIC THERAPY, INC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Plan administrator’s name and address
Administrator’s EIN 411618385
Plan administrator’s name CAPERNAUM PEDIATRIC THERAPY, INC
Plan administrator’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435
Administrator’s telephone number 9522852840

Signature of
Role Plan administrator
Date 2012-06-13
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-13
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2010 411618385 2011-05-11 CAPERNAUM PEDIATRIC THERAPY, INC 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Plan administrator’s name and address
Administrator’s EIN 411618385
Plan administrator’s name CAPERNAUM PEDIATRIC THERAPY, INC
Plan administrator’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435
Administrator’s telephone number 9522852840

Signature of
Role Plan administrator
Date 2011-05-11
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature
CAPERNAUM PEDIATRIC THERAPY, INC RETIREMENT PLAN 2009 411618385 2010-07-18 CAPERNAUM PEDIATRIC THERAPY, INC 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621340
Sponsor’s telephone number 9522852840
Plan sponsor’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435

Plan administrator’s name and address
Administrator’s EIN 411618385
Plan administrator’s name CAPERNAUM PEDIATRIC THERAPY, INC
Plan administrator’s address 7250 FRANCE AVENUE SOUTH, SUITE 305, EDINA, MN, 55435
Administrator’s telephone number 9522852840

Signature of
Role Plan administrator
Date 2010-06-28
Name of individual signing BONNA OLSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
Bonna Olson Agent

Chief Executive Officer

Name Role Address
Alison Bicek Chief Executive Officer STE 430, 6625 LYNDALE AVE S, RICHFIELD, MN 55423–2300, USA

Filing

Filing Name Filing date
Amendment - Business Corporation (Domestic)Restated Articles 2021-04-16
Registered Office and/or Agent - Business Corporation (Domestic) 2016-04-15
Business Corporation (Domestic) Business Name (Business Name: CAPERNAUM PEDIATRIC THERAPY, INC.) 1998-01-06
Original Filing - Business Corporation (Domestic) 1988-07-22
Business Corporation (Domestic) Business Name (Business Name: Capernaum Pediatric Physical Therapy, Inc.) 1988-07-22

Related by officers

Bonna Olson

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Related by address

No related companies by address

Date of last update: 10 Jan 2025

Sources: Minnesota's Official State Website

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