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Lighthouse Counseling Center, Inc.

Details

Name: Lighthouse Counseling Center, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 26 Jul 1971 (53 years ago) (Companies founded in July 1971)
Entity Number: 000-765-304
Register Number: 000765304
Historical Names: The Lighthouse
The Lighthouse Counseling Center, Inc.
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL

Activities MAINTAIN A CHARITY CLINIC

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1649266859 2005-09-22 2008-07-02 1415 E SOUTH BLVD, MONTGOMERY, AL, 361162319, US 1415 E SOUTH BLVD, MONTGOMERY, AL, 361162319, US

Contacts
Phone +1 334-286-5980
Fax 3342865993

Authorized person
Name MRS. CANDYCE L DEKRUYFF
Role EXECUTIVE DIRECTOR
Phone 3342865980

Taxonomy
Taxonomy Code 251B00000X - Case Management Agency
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 330034061
State AL

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
368Y7 Obsolete Non-Manufacturer 2005-03-07 2023-06-07 2023-06-06 No data

Contact Information
POC JAMES TALTON
Phone +1 334-286-5980
Fax +1 334-286-5988
Address 111 COLISEUM BLVD, MONTGOMERY, AL, 36109 2707, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2018 237126914 2019-07-01 LIGHTHOUSE COUNSELING CENTER, INC. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2019-07-01
Name of individual signing JONATHAN YARBORO
Role Employer/plan sponsor
Date 2019-07-01
Name of individual signing JONATHAN YARBORO
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2017 237126914 2019-02-26 LIGHTHOUSE COUNSELING CENTER, INC. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2019-02-26
Name of individual signing JOY MCMULLIN
Role Employer/plan sponsor
Date 2019-02-26
Name of individual signing JOY MCMULLIN
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2016 237126914 2018-07-06 LIGHTHOUSE COUNSELING CENTER, INC. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2018-07-06
Name of individual signing JOY MCMULLIN
Role Employer/plan sponsor
Date 2018-07-06
Name of individual signing JOY MCMULLIN
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2015 237126914 2017-06-29 LIGHTHOUSE COUNSELING CENTER, INC. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing TINA BUSH
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2014 237126914 2016-04-28 LIGHTHOUSE COUNSELING CENTER, INC. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2016-04-28
Name of individual signing TINA BUSH
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2013 237126914 2015-02-02 LIGHTHOUSE COUNSELING CENTER, INC. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2015-01-30
Name of individual signing TINA BUSH
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2012 237126914 2014-04-25 LIGHTHOUSE COUNSELING CENTER, INC. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 111 COLISEUM BOULEVARD, MONTGOMERY, AL, 36109

Signature of
Role Plan administrator
Date 2014-04-25
Name of individual signing TINA BUSH
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2011 237126914 2013-07-03 LIGHTHOUSE COUNSELING CENTER, INC. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116

Plan administrator’s name and address
Administrator’s EIN 237126914
Plan administrator’s name LIGHTHOUSE COUNSELING CENTER, INC.
Plan administrator’s address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116
Administrator’s telephone number 3342865980

Signature of
Role Plan administrator
Date 2013-07-03
Name of individual signing TINA BUSH
Role Employer/plan sponsor
Date 2013-07-03
Name of individual signing TINA BUSH
LIGHTHOUSE COUNSELING CENTER, INC. 401(K) PLAN 2010 237126914 2012-07-02 LIGHTHOUSE COUNSELING CENTER, INC. 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 813000
Sponsor’s telephone number 3342865980
Plan sponsor’s address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116

Plan administrator’s name and address
Administrator’s EIN 237126914
Plan administrator’s name LIGHTHOUSE COUNSELING CENTER, INC.
Plan administrator’s address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116
Administrator’s telephone number 3342865980

Signature of
Role Plan administrator
Date 2012-06-29
Name of individual signing TINA HINES
LIGHTHOUSE COUNSELING CENTER, INC 401 (K) PLAN 2009 237126914 2010-07-13 LIGHTHOUSE COUNSELING CENTER, INC No data
File View Page
Three-digit plan number (PN) 002
Plan sponsor’s mailing address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116
Plan sponsor’s address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116

Plan administrator’s name and address
Administrator’s EIN 237126914
Plan administrator’s name LIGHTHOUSE COUNSELING CENTER, INC
Plan administrator’s address 1415 EAST SOUTH BOULEVARD, MONTGOMERY, AL, 36116

Incorporator

Name Role
WOOL, VERNA L Incorporator
WOOL, JACK Incorporator
MANNING, RONALD Incorporator

Events

Event Date Event Type Old Value New Value
2007-05-31 Name Merged No data Lighthouse Help, Inc.
2002-10-31 Name Merged No data Alternatives, Inc.
2002-10-31 Name Change The Lighthouse Counseling Center, Inc. Lighthouse Counseling Center, Inc.
1985-09-19 Name Change The Lighthouse The Lighthouse Counseling Center, Inc.

Related by officers

WOOL, VERNA L

Verna L. Wool, PhD., P.A.

WOOL, JACK

Courts, Inc. Jack Wool, M.D., P.A. Wool Real Estate Holdings, Ltd. The Wool Family Foundation

Related by address

MONTGOMERY, AL

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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