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Quality of Life Health Services, Inc.

Details

Name: Quality of Life Health Services, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 20 Apr 1977 (48 years ago) (Companies founded in April 1977)
Entity Number: 000-814-289
Register Number: 000814289
Historical Names: Etowah Quality of Life Council, Inc.
ZIP code: 35904 (Companies in Etowah, 35904)
County: Etowah
Place of Formation: Etowah County
Registered Office Street Address: 201 WALL STREETGADSDEN, AL 35904

Activities ANY LAWFUL ACTIVITY DEALING WITH PRIMARY HEALTH CARE FACILITIES

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
V65MRBGWJNY6 2024-07-12 1411 PIEDMONT CUTOFF, GADSDEN, AL, 35903, 2708, USA P.O. BOX # 97, GADSDEN, AL, 35902, 0097, USA

Business Information
URL http://www.qolhs.org
Congressional District 04
State/Country of Incorporation AL, USA
Activation Date 2023-07-18
Initial Registration Date 2006-01-11
Entity Start Date 1977-11-01
Fiscal Year End Close Date Mar 31

Service Classifications
NAICS Codes 621498

Points of Contacts
Electronic Business
Title PRIMARY POC
Name WAYNE ROWE
Role MR.
Address P.O. BOX # 97, GADSDEN, AL, 35902, 0097, USA
Government Business
Title PRIMARY POC
Name WAYNE C. ROWE
Role MR.
Address P.O. BOX # 97, GADSDEN, AL, 35902, 0097, USA
Past Performance
Title PRIMARY POC
Name WAYNE ROWE
Address P.O. BOX # 97, GADSDEN, AL, 35902, 0097, USA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780123372 2017-02-16 2017-02-16 PO BOX 97, GADSDEN, AL, 359020097, US 404 9TH AVE SW, LAFAYETTE, AL, 368622806, US

Contacts
Phone +1 256-492-0131

Authorized person
Name MR. WAYNE C ROWE
Role CEO
Phone 2564920131

Taxonomy
Taxonomy Code 261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary Yes

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
49CL8 Active Non-Manufacturer 2006-01-12 2024-07-15 2029-07-15 2025-07-11

Contact Information
POC WAYNE C.. ROWE
Phone +1 256-553-0457
Fax +1 256-494-6000
Address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 35903 2708, 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
QUALITY OF LIFE HEALTH SERVICES, INC LLOYDS 2023 630727804 2024-07-17 QUALITY OF LIFE HEALTH SERVICES INC 166
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2023-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 169

Signature of
Role Plan administrator
Date 2024-07-17
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-17
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
QUALITY OF LIFE HEALTH SERVICES, INC PRINCIPAL 2023 630727804 2024-07-10 QUALITY OF LIFE HEALTH SERVICES, INC 166
File View Page
Three-digit plan number (PN) 507
Effective date of plan 2023-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 166

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-10
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
THE STANDARD 2023 630727804 2024-07-10 QUALITY OF LIFE HEALTH SERVICES, INC 188
File View Page
Three-digit plan number (PN) 508
Effective date of plan 2023-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 18

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-10
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
BLUE CROSS BLUE SHIELD OF ALABAMA 2023 630727804 2024-07-10 QUALITY OF LIFE HEALTH SERVICES INC 167
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2023-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 170

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-10
Name of individual signing TIFFANY FRANKS
Valid signature Filed with authorized/valid electronic signature
BLUE CROSS BLUE SHIELD OF ALABAMA 2022 630727804 2023-07-24 QUALITY OF LIFE HEALTH SERVICES, INC. 171
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2022-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 167

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
QUALITY OF LIFE HEALTH SERVICES, INC. PRINCIPAL 2022 630727804 2023-07-24 QUALITY OF LIFE HEALTH SERVICES, INC. 173
File View Page
Three-digit plan number (PN) 507
Effective date of plan 2022-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 173

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
QUALITY OF LIFE HEALTH SERVICES, INC. LLOYDS 2022 630727804 2023-07-24 QUALITY OF LIFE HEALTH SERVICES, INC. 167
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2022-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 166

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
THE STANDARD 2022 630727804 2023-07-24 QUALITY OF LIFE HEALTH SERVICES, INC. 187
File View Page
Three-digit plan number (PN) 508
Effective date of plan 2022-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 188

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-24
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
QUALITY OF LIFE HEALTH SERVICES, INC. LLOYDS 2021 630727804 2022-07-26 QUALITY OF LIFE HEALTH SERVICES, INC. 189
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2021-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 167

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-26
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
VSP 2021 630727804 2022-07-26 QUALITY OF LIFE HEALTH SERVICES, INC. 176
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2021-04-01
Business code 621498
Sponsor’s telephone number 2564920131
Plan sponsor’s mailing address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708
Plan sponsor’s address 1411 PIEDMONT CUTOFF, GADSDEN, AL, 359032708

Number of participants as of the end of the plan year
Active participants 195

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-26
Name of individual signing TRACIE WILLIAMS
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role Address
TARGET MANAGEMENT TRUST Incorporator No data
TARGET MANAGEMENT HOLDINGS Incorporator 201 WALL STREETGADSDEN, AL 35904
BETHLEHEM MANAGEMENT Incorporator 201 WALL STREETGADSDEN, AL 35904

Agent

Name Role
TARGET MANAGEMENT TRUST Agent

Events

Event Date Event Type Old Value New Value
1995-09-20 Name Change Etowah Quality of Life Council, Inc. Quality of Life Health Services, Inc.

Related by officers

TARGET MANAGEMENT TRUST

Vision, Inc. Enrestoration, Inc. ALM TR INC

TARGET MANAGEMENT HOLDINGS

Target Management, LLC The Bethesda Life Center, Inc.

BETHLEHEM MANAGEMENT

Enrestoration, Inc.

Related by address

201 WALL STREETGADSDEN, AL 35904

Vision, Inc. Target Management, LLC The Bethesda Life Center, Inc. Target Management Trust ALM TR INC

Date of last update: 16 Aug 2024

Sources: Alabama Secretary of State

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