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  5. NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC.

NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC.

Company Details

Entity Name: NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Merged
Date Formed: 19 Dec 1975
Business ALEI: 0058164
Annual report due: 28 Dec 2019
Business address: 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708
ZIP code: 06708
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: jsw@nwrmhb-ct.org

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2018 060942683 2019-10-29 NORTHWEST REGIONAL MENTAL HEALTH BOARD 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037577603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2019-10-29
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2018 060942683 2019-05-23 NORTHWEST REGIONAL MENTAL HEALTH BOARD 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037577603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2019-05-23
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2017 060942683 2018-09-04 NORTHWEST REGIONAL MENTAL HEALTH BOARD 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037579603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2018-09-04
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2016 060942683 2017-09-26 NORTHWEST REGIONAL MENTAL HEALTH BOARD No data
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Sponsor’s telephone number 2037579603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2017-09-26
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2016 060942683 2017-10-02 NORTHWEST REGIONAL MENTAL HEALTH BOARD 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037577603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2017-10-02
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2015 060942683 2016-10-13 NORTHWEST REGIONAL MENTAL HEALTH BOARD 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037577603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2014 060942683 2015-07-10 NORTHWEST REGIONAL MENTAL HEALTH BOARD No data
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Sponsor’s telephone number 2037579603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2015-07-10
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2014 060942683 2015-10-13 NORTHWEST REGIONAL MENTAL HEALTH BOARD 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037579603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2013 060942683 2014-10-09 NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037577603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2014-10-09
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature
NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. PENSION PLAN 2012 060942683 2013-10-09 NORTHWEST REGIONAL MENTAL HEALTH BOARD, INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1989-03-01
Business code 813000
Sponsor’s telephone number 2037579603
Plan sponsor’s address 969 WEST MAIN STREET SUITE 1B, WATERBURY, CT, 06708

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing JANINE SULLIVAN-WILEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role E-Mail Residence address
RENATO RICCIUTI Agent jsw@nwrmhb-ct.org 49 PRIMROSE ST, WATERBURY, CT, 06708, United States

Officer

Name Role Business address Residence address
RON CLARK Officer No data 133 STEINMANN AVENUE, MIDDLEBURY, CT, 06762, United States
NANCY J. CANNAVO Officer CHARLOTTE HUGERFORD HOSPITAL, 540 LITCHFIELD ROAD, LITCHFIELD, CT, 06790, United States 121 OLD NORTH ROAD, WINCHESTER, CT, 06098, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CHR.0013226-EXEMPT PUBLIC CHARITY-EXEMPT FROM FINANCIAL REQUIREMENTS ACTIVE No data 2005-09-19 No data No data

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0006616528 2019-08-07 2019-08-07 Merger Certificate of Merger No data
0006295707 2018-12-19 No data Annual Report Annual Report 2018
0005988350 2017-12-20 No data Annual Report Annual Report 2017
0005723673 2016-12-22 No data Annual Report Annual Report 2016
0005456481 2015-12-31 No data Annual Report Annual Report 2015
0005240608 2014-12-23 No data Annual Report Annual Report 2014
0005005965 2013-12-23 No data Annual Report Annual Report 2013
0004767952 2012-12-20 No data Annual Report Annual Report 2012
0004660477 2011-12-15 No data Annual Report Annual Report 2011
0004369149 2010-12-23 No data Annual Report Annual Report 2010

Related by officers

RON CLARK

HEALTHSOUTH IMC, INC.

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Connecticut's Official State Website

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