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Hospice Family Care

Details

Name: Hospice Family Care
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Dissolved
Date of registration: 16 Aug 1993 (31 years ago)
Date of dissolution: 22 Jun 2021
Entity Number: 000-075-739
Register Number: 000075739
Historical Names: Huntsville Hospice Cares, Inc.
County: Madison
Place of Formation: Madison County
Principal Address: HUNTSVILLE, AL
Registered Office Street Address: 509 MADISON STREETHUNTSVILLE, AL 35801
Registered Office Street Address ZIP Code: 35801

Activities SERVICE/SUPPORT FOR TERMINALLY ILL & THEIR FAMILIES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1023094042 2005-12-21 2022-07-21 3304 WESTMILL DR SW, HUNTSVILLE, AL, 358056132, US 10000 SERENITY LANE SE, HUNTSVILLE, AL, 35803, US

Contacts
Phone +1 256-650-1212
Fax 2568802929

Authorized person
Name MRS. KRISTINA JOHNSON
Role EXECUTIVE DIRECTOR
Phone 2566501212

Taxonomy
Taxonomy Code 251G00000X - Community Based Hospice Care Agency
License Number 11171
State AL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number 010-674
State AL
Issuer MEDICAID
Number PIC1505E
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2016 630820386 2019-08-05 HOSPICE FAMILY CARE 51
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 358056119

Signature of
Role Plan administrator
Date 2019-08-05
Name of individual signing JAMIE POSEY
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2015 630820386 2017-01-18 HOSPICE FAMILY CARE 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 358056119

Signature of
Role Plan administrator
Date 2017-01-18
Name of individual signing JAMIE POSEY
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2014 630820386 2016-04-15 HOSPICE FAMILY CARE 56
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622200
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805

Signature of
Role Plan administrator
Date 2016-04-15
Name of individual signing JAMIE POSEY
Role Employer/plan sponsor
Date 2016-04-15
Name of individual signing JAMIE POSEY
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2013 630820386 2015-04-15 HOSPICE FAMILY CARE 56
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805

Signature of
Role Plan administrator
Date 2015-04-15
Name of individual signing FORREST BRIGGS
Role Employer/plan sponsor
Date 2015-04-15
Name of individual signing FORREST BRIGGS
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2012 630820386 2014-03-17 HOSPICE FAMILY CARE 63
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805

Signature of
Role Plan administrator
Date 2014-03-17
Name of individual signing JAMIE POSEY
Role Employer/plan sponsor
Date 2014-03-17
Name of individual signing JAMIE POSEY
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2011 630820386 2013-01-24 HOSPICE FAMILY CARE 58
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805

Plan administrator’s name and address
Administrator’s EIN 630820386
Plan administrator’s name HOSPICE FAMILY CARE
Plan administrator’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805
Administrator’s telephone number 2566501212

Signature of
Role Plan administrator
Date 2013-01-24
Name of individual signing MARY BRAINERD
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2010 630820386 2013-03-26 HOSPICE FAMILY CARE 61
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805

Plan administrator’s name and address
Administrator’s EIN 630820386
Plan administrator’s name HOSPICE FAMILY CARE
Plan administrator’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805
Administrator’s telephone number 2566501212

Signature of
Role Plan administrator
Date 2012-01-25
Name of individual signing MARY BRAINERD
Role Employer/plan sponsor
Date 2012-01-25
Name of individual signing GREGORY MARTIN
403(B) THRIFT PLAN OF HOSPICE FAMILY CARE 2009 630820386 2011-01-26 HOSPICE FAMILY CARE 60
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-07-01
Business code 622000
Sponsor’s telephone number 2566501212
Plan sponsor’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805

Plan administrator’s name and address
Administrator’s EIN 630820386
Plan administrator’s name HOSPICE FAMILY CARE
Plan administrator’s address 3304 WESTMILL DR SW, HUNTSVILLE, AL, 35805
Administrator’s telephone number 2566501212

Signature of
Role Plan administrator
Date 2011-01-26
Name of individual signing MARY BRAINERD
Role Employer/plan sponsor
Date 2011-01-26
Name of individual signing GREGORY MARTIN

Agent

Name Role
HELMAN, FLORENCE Agent

Incorporator

Name Role
RICKEY, SHARON Incorporator
WOOD, EMILY C Incorporator

Events

Event Date Event Type Old Value New Value
1998-02-09 Name Merged No data Hospice of Huntsville
1998-02-09 Name Change Huntsville Hospice Cares, Inc. Hospice Family Care

Related by officers

No related officers

Related by address

HUNTSVILLE, AL

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509 MADISON STREETHUNTSVILLE, AL 35801

Huntsville Emergency Medical Associates, P.A. Barack, PLLC Cheatham Group, LLC

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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