| Name: | Extendicare, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 04 Jan 1979 (46 years ago) (Companies founded in January 1979) |
| Entity Number: | 000-054-409 |
| Register Number: | 000054409 |
| Place of Formation: | Houston County |
| Principal Address: | DOTHAN, AL |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | $5,000 |
Activities
NURSING HOME
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487669115 | 2006-07-30 | 2024-02-29 | PMB 391, 104 APPLE AVE SUITE 3, DOTHAN, AL, 36303, US | 950 S SAINT ANDREWS ST, DOTHAN, AL, 363013684, US | |||||||||||||||||||||||||
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| Phone | +1 334-793-1177 |
| Fax | 3346993948 |
Authorized person
| Name | DAVID DENNIS |
| Role | CEO |
| Phone | 3347931177 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | N3501 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4757020S |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EXTENDICARE, INC. 401(K) RETIREMENT PLAN | 2023 | 630771566 | 2024-06-26 | EXTENDICARE, INC. | 276 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-06-26 |
| Name of individual signing | JAMES DENNIS |
| Name | Role | Address |
|---|---|---|
| DENNIS, DAVID T | Incorporator | No data |
| DENNIS, JANET S | Incorporator | No data |
| BECK, CAROLYN H | Incorporator | 3941 OLD SULFUR SPRING RDWELLINTON, AL 36279 |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
