Centrum ABA LLC

Details

Name:	Centrum ABA LLC
Jurisdiction:	Alabama
Legal type:	Domestic Professional Limited Liability Company
Status:	Exists
Date of registration:	13 Aug 2018 (6 years ago)
Entity Number:	000-526-673
Register Number:	000526673
County:	Dale
Place of Formation:	Coffee County
Registered Office Street Address:	181 W REYNOLDS ST.OZARDK, AL 36360
Registered Office Street Address ZIP Code:	36360

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1871072793

2018-08-10

2018-08-10

25 COURTYARD WAY, ENTERPRISE, AL, 363305054, US

25 COURTYARD WAY, ENTERPRISE, AL, 363305054, US

Contacts

Phone

+1 334-477-4686

Authorized person

Name	SHELBY DIPILLA
Role	OWNER
Phone	3344774686

Taxonomy

Taxonomy Code	251S00000X - Community/Behavioral Health Agency
Is Primary	Yes

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

BEACON OF HOPE 401(K) PLAN

2023

831520756

2024-07-03

CENTRUM ABA

45

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621112
Sponsor’s telephone number	3344774686
Plan sponsor’s address	181 W REYNOLDS ST, OZARK, AL, 36360

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2024-07-02
Name of individual signing	QIAN LIU

BEACON OF HOPE 401(K) PLAN

2022

831520756

2023-08-11

CENTRUM ABA

39

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621112
Sponsor’s telephone number	3344774686
Plan sponsor’s address	181 W REYNOLDS ST, OZARK, AL, 36360

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2023-08-11
Name of individual signing	CHRISTINE RIMER

BEACON OF HOPE 401(K) PLAN

2021

831520756

2022-05-31

CENTRUM ABA

18

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621112
Sponsor’s telephone number	3344774686
Plan sponsor’s address	181 W REYNOLDS ST, OZARK, AL, 36360

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2022-05-31
Name of individual signing	CHRISTINE RIMER

BEACON OF HOPE 401(K) PLAN

2020

831520756

2021-06-17

CENTRUM ABA

0

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2020-01-01
Business code	621112
Sponsor’s telephone number	3344774686
Plan sponsor’s address	181 W REYNOLDS ST, OZARK, AL, 36360

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2021-06-16
Name of individual signing	CAROL HO

Agent

Name	Role	Address
DIPILLA, SHELBY	Agent	222 CLEARVIEW DRIVEENTERPRISE, AL 36330

Organizer

Name	Role	Address
BECERRA, SONIA	Organizer	3 Greenway Plaza #1320Houston, TX 77046

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State