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Lauderdale Christian Nursing Home

Details

Name: Lauderdale Christian Nursing Home
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 01 Sep 1966 (58 years ago)
Entity Number: 000-815-410
Register Number: 000815410
County: Lauderdale
Place of Formation: Lauderdale County
Principal Address: KILLEN, AL
Registered Office Street Address: 2019 COUNTY ROAD 394KILLEN, AL 35645
Registered Office Street Address ZIP Code: 35645

Activities CONSTRUCT/MANAGE/OPERATE SAID PROPERTY/NURSING HOME

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598750994 2005-09-13 2011-09-20 2019 COUNTY ROAD 394, KILLEN, AL, 356455525, US 2019 COUNTY ROAD 394, KILLEN, AL, 356455525, US

Contacts
Phone +1 256-757-2103
Fax 2567572233

Authorized person
Name MR. TIMOTHY LEE MORROW
Role ADMINISTRATOR
Phone 2567572103

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 10580
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 4753610S
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAUDERDALE CHRISTIAN NURSING HOME 2023 630568257 2024-09-11 LAUDERDALE CHRISTIAN NURSING HOME 141
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 140

Signature of
Role Plan administrator
Date 2024-09-10
Name of individual signing ANNETTE PARKER
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2022 630568257 2023-11-10 LAUDERDALE CHRISTIAN NURSING HOME 137
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 141

Signature of
Role Plan administrator
Date 2023-11-09
Name of individual signing ANNETTE PARKER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-11-09
Name of individual signing ANNETTE PARKER
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2020 630568257 2021-09-20 LAUDERDALE CHRISTIAN NURSING HOME 121
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 132

Signature of
Role Plan administrator
Date 2021-09-17
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-17
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2019 630568257 2020-08-31 LAUDERDALE CHRISTIAN NURSING HOME 125
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 121

Signature of
Role Plan administrator
Date 2020-08-31
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-31
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2018 630568257 2019-08-19 LAUDERDALE CHRISTIAN NURSING HOME 120
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 125

Signature of
Role Plan administrator
Date 2019-08-19
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-19
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2018 630568257 2019-01-07 LAUDERDALE CHRISTIAN NURSING HOME 119
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 120

Signature of
Role Plan administrator
Date 2019-01-07
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-01-07
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2017 630568257 2018-10-25 LAUDERDALE CHRISTIAN NURSING HOME 125
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 119

Signature of
Role Plan administrator
Date 2018-10-25
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-25
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2016 630568257 2017-07-26 LAUDERDALE CHRISTIAN NURSING HOME 121
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 125

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2015 630568257 2016-07-21 LAUDERDALE CHRISTIAN NURSING HOME 117
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 356455525

Number of participants as of the end of the plan year
Active participants 121

Signature of
Role Plan administrator
Date 2016-07-21
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-21
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
LAUDERDALE CHRISTIAN NURSING HOME 2014 630568257 2015-06-29 LAUDERDALE CHRISTIAN NURSING HOME 108
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2011-01-01
Business code 623000
Sponsor’s telephone number 2567572103
Plan sponsor’s mailing address 2019 COUNTY ROAD 394, KILLEN, AL, 35645
Plan sponsor’s address 2019 COUNTY ROAD 394, KILLEN, AL, 35645

Number of participants as of the end of the plan year
Active participants 117

Signature of
Role Plan administrator
Date 2015-06-29
Name of individual signing TIM MORROW
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2015-06-25
Name of individual signing DAVID WILSON
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role
COKER, C A Incorporator
HAMNER, HERSHEL Incorporator
HUNTER, ANDREW Incorporator

Agent

Name Role
COTTRELL, LOUIS E JR Agent

Related by officers

COKER, C A

North Alabama Christian Children's Home

HUNTER, ANDREW

AJH, Inc.

Related by address

KILLEN, AL

Piggly-Wiggly of Killen, Alabama, Inc. R & D Trucking Company, Inc. Smith Brothers Builders, Inc. Frontier Electric, Inc. North Alabama Testing Company, Inc. The Rod & Gun Shop, Inc. Alten Drugs, Inc. Lexington Servicenter, Inc. MEGA RESEARCH, INC. Robbins Interior Surfaces, Inc.

Date of last update: 16 Aug 2024

Sources: Alabama Secretary of State

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