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Self Health Care & Rehab Center, Inc.

Details

Name: Self Health Care & Rehab Center, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 23 Nov 2004 (20 years ago)
Entity Number: 000-238-436
Register Number: 000238436
County: Jefferson
Place of Formation: Jefferson County
Principal Address: HUEYTOWN, AL
Registered Office Street Address: 131 CREST RDHUEYTOWN, AL 35023
Registered Office Street Address ZIP Code: 35023
Authorized Capital: $100

Activities LEASE/OPERATE A HEALTHCARE/REHABILITATION CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235114901 2005-12-14 2012-04-05 131 E CREST RD, HUEYTOWN, AL, 350231623, US 131 E CREST RD, HUEYTOWN, AL, 350231623, US

Contacts
Phone +1 205-491-2411
Fax 2054918750

Authorized person
Name J A SELF JR.
Role OWNER ADMINISTRATOR
Phone 2054912411

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 11106
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 4753430S
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2020 320133776 2021-02-17 SELF HEALTH CARE & REHAB CENTER, INC. 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2021-02-17
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2019 320133776 2020-03-03 SELF HEALTH CARE & REHAB CENTER, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2020-03-03
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2020-03-03
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2018 320133776 2019-02-27 SELF HEALTH CARE & REHAB CENTER, INC. 72
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2019-02-27
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2019-02-27
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2017 320133776 2018-02-16 SELF HEALTH CARE & REHAB CENTER, INC. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2018-02-16
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2018-02-16
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2016 320133776 2017-03-10 SELF HEALTH CARE & REHAB CENTER, INC. 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2017-03-10
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2017-03-10
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2015 320133776 2016-06-21 SELF HEALTH CARE & REHAB CENTER, INC. 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2016-06-21
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2016-06-21
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2014 320133776 2015-02-27 SELF HEALTH CARE & REHAB CENTER, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2015-02-27
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2015-02-27
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2013 320133776 2014-03-13 SELF HEALTH CARE & REHAB CENTER, INC. 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2014-03-13
Name of individual signing ANDY SELF
Role Employer/plan sponsor
Date 2014-03-13
Name of individual signing ANDY SELF
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2012 320133776 2013-01-31 SELF HEALTH CARE & REHAB CENTER, INC. 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Signature of
Role Plan administrator
Date 2013-01-31
Name of individual signing DEB SAVINCKI
Role Employer/plan sponsor
Date 2013-01-31
Name of individual signing DEB SAVINCKI
SELF HEALTH CARE & REHAB CENTER, INC. 401(K) RETIREMENT PLAN 2011 320133776 2012-03-20 SELF HEALTH CARE & REHAB CENTER, INC. 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 2054912411
Plan sponsor’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506

Plan administrator’s name and address
Administrator’s EIN 320133776
Plan administrator’s name SELF HEALTH CARE & REHAB CENTER, INC.
Plan administrator’s address 131 CREST ROAD, HUEYTOWN, AL, 350231506
Administrator’s telephone number 2054912411

Signature of
Role Plan administrator
Date 2012-03-20
Name of individual signing DEBRA SAVINCKI
Role Employer/plan sponsor
Date 2012-03-20
Name of individual signing DEBRA SAVINCKI

Agent

Name Role
SELF, JASPER A JR Agent

Incorporator

Name Role Address
MCCLANAHAN, RANDALL D Incorporator 1819 FIFTH AVE N STE 1000BIRMINGHAM, AL 35203

Related by officers

SELF, JASPER A JR

V. A. L. Corporation

MCCLANAHAN, RANDALL D

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Related by address

HUEYTOWN, AL

Bobby Allison Promotions, Inc. Bobby Allison Racing, Inc. McLeod Realty Company, Inc. Robert Shirley Cabinets, Inc. Putnam's Florist Rex Realty Company, Inc. Self Nursing Home, Inc. Sherrod Homes, Inc. Vines Plumbing Company, Inc. Weldon Pharmacy, Inc.

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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