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PELLEGRINO HEALING CENTER, LLC

Company Details

Name: PELLEGRINO HEALING CENTER, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 04 Oct 2018 (6 years ago) (Companies founded in October 2018)
Entity Number: 5420356
ZIP code: 12586 (Companies in Dutchess, 12586)
County: Dutchess
Place of Formation: New York
Address: 220 BEL AIR ROAD, WALDEN, NY, United States, 12586

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PELLEGRINO HEALING CENTER 401(K) PLAN 2023 832185387 2024-05-31 PELLEGRINO HEALING CENTER 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-05-31
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2022 832185387 2024-05-24 PELLEGRINO HEALING CENTER 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-05-24
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2022 832185387 2023-08-18 PELLEGRINO HEALING CENTER 4
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-08-18
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2021 832185387 2022-09-23 PELLEGRINO HEALING CENTER 3
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing TARA EVANS
PELLEGRINO HEALING CENTER 401(K) PLAN 2021 832185387 2023-08-17 PELLEGRINO HEALING CENTER 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-08-17
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2020 832185387 2021-10-01 PELLEGRINO HEALING CENTER 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-10-01
Name of individual signing PHIL TISUE

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 220 BEL AIR ROAD, WALDEN, NY, United States, 12586

Filings

Filing Number Date Filed Type Effective Date
181127000615 2018-11-27 CERTIFICATE OF PUBLICATION 2018-11-27
181004000116 2018-10-04 ARTICLES OF ORGANIZATION 2018-10-04

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Date of last update: 22 Nov 2024

Sources: New York Secretary of State

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