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Provident Home Healthcare, LLC

Company Details

Name: Provident Home Healthcare, LLC
Jurisdiction: Minnesota
Legal type: Limited Liability Company (Domestic)
Status: Active / In Good Standing
Date formed: 27 Aug 2009 (15 years ago)
Company Number: d6e62e7b-94d4-e011-a886-001ec94ffe7f
File Number: 3470910-2
Registered Office Address: 2852 Anthony Lane South, St. Anthony, MN 55418, USA
Principal Executive Office Address: 2852 ANTHONY LN S, ST ANTHONY, MN 55418–3287, USA
ZIP code: 55418
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2014 270832417 2015-07-02 PROVIDENT HOME HEALTHCARE, LLC 87
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621610
Sponsor’s telephone number 6122384688
Plan sponsor’s address 2817 ANTHONY LANE S., SUITE 301, ST. ANTHONY, MN, 55418

Signature of

Role Plan administrator
Date 2015-07-02
Name of individual signing RAMONA ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-02
Name of individual signing RAMONA ERICKSON
Valid signature Filed with authorized/valid electronic signature
PROVIDENT HOME HEALTHCARE, LLC 401(K) PLAN 2013 270832417 2014-09-17 PROVIDENT HOME HEALTHCARE, LLC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621610
Sponsor’s telephone number 6122384688
Plan sponsor’s address 2817 ANTHONY LANE S., SUITE 301, ST. ANTHONY, MN, 55418

Signature of

Role Plan administrator
Date 2014-09-17
Name of individual signing RAMONA ERICKSON
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role Address
Mitchell J. Erickson Manager 2852 ANTHONY LN S, ST ANTHONY, MN 55418–3287, USA

Agent

Name Role
Ramona Erickson Agent

Filing

Filing Name Filing date
Registered Office and/or Agent - Limited Liability Company (Domestic) 2021-01-27
Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) 2018-01-01
Original Filing - Limited Liability Company (Domestic) 2009-08-27
Limited Liability Company (Domestic) Business Name (Business Name: Provident Home Healthcare, LLC) 2009-08-27

Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website