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  5. CHARTER OAK HEALTH CENTER, INC.

CHARTER OAK HEALTH CENTER, INC.

Company Details

Entity Name: CHARTER OAK HEALTH CENTER, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 15 May 1978
Business ALEI: 0075538
Annual report due: 15 May 2025
NAICS code: 621498 - All Other Outpatient Care Centers
Business address: 21 GRAND STREET, HARTFORD, CT, 06106, United States
Mailing address: CHARTER OAK HEALTH CENTER, INC. 21 GRAND STREET, HARTFORD, CT, United States, 06106
ZIP code: 06106
County: Hartford
Place of Formation: CONNECTICUT
E-Mail: tpowers@thecharteroak.org

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
HLCRU27NKFG9 2024-08-23 21 GRAND ST, HARTFORD, CT, 06106, 1541, USA 21 GRAND ST, HARTFORD, CT, 06106, 1541, USA

Business Information
URL http://www.thecharteroak.org/
Congressional District 01
State/Country of Incorporation CT, USA
Activation Date 2023-08-28
Initial Registration Date 2004-08-12
Entity Start Date 1978-05-15
Fiscal Year End Close Date Jun 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name TIM POWERS
Role VICE PRESIDENT OF COMPLIANCE
Address 21 GRAND STREET, HARTFORD, CT, 06106, 1541, USA
Title ALTERNATE POC
Name NICHELLE A MULLINS
Address 21 GRAND STREET, HARTFORD, CT, 06106, USA
Government Business
Title PRIMARY POC
Name TIM POWERS
Role VICE PRESIDENT OF COMPLIANCE
Address 21 GRAND STREET, HARTFORD, CT, 06106, USA
Title ALTERNATE POC
Name DAVID CONLEY
Role CONTROLLER
Address 21 GRAND STREET, HARTFORD, CT, 06106, USA
Past Performance
Title PRIMARY POC
Name NICHELLE A MULLINS
Address 21 GRAND STREET, HARTFORD, CT, 06106, USA
Title ALTERNATE POC
Name DAVID CONLEY
Role CONTROLLER
Address 21 GRAND STREET, HARTFORD, CT, 06106, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3ZKF5 Obsolete Non-Manufacturer 2004-08-13 2024-07-03 No data 2025-07-01

Contact Information
POC TIM POWERS
Phone +1 860-550-7500
Fax +1 860-550-7529
Address 21 GRAND ST, HARTFORD, CT, 06106 1541, 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
CHARTER OAK HEALTH CENTER HEALTH AND WELFARE PLAN 2013 066033492 2014-09-05 CHARTER OAK HEALTH CENTER, INC. 176
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2013-02-01
Business code 621498
Sponsor’s telephone number 8605507500
Plan sponsor’s mailing address 21 GRAND STREET, HARTFORD, CT, 06106
Plan sponsor’s address 21 GRAND STREET, HARTFORD, CT, 06106

Number of participants as of the end of the plan year
Active participants 172
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2014-09-05
Name of individual signing NICHELLE MULLINS
Valid signature Filed with authorized/valid electronic signature
CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2012 060986747 2013-10-07 CHARTER OAK HEALTH CENTER 115
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8605507500
Plan sponsor’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541

Signature of
Role Plan administrator
Date 2013-10-07
Name of individual signing NAVIN SANGOI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-07
Name of individual signing NAVIN SANGOI
Valid signature Filed with authorized/valid electronic signature
CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2011 060986747 2012-09-24 CHARTER OAK HEALTH CENTER 120
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8605507500
Plan sponsor’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541

Plan administrator’s name and address
Administrator’s EIN 060986747
Plan administrator’s name CHARTER OAK HEALTH CENTER
Plan administrator’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541
Administrator’s telephone number 8605507500

Signature of
Role Plan administrator
Date 2012-09-24
Name of individual signing NAVIN SANGOI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-24
Name of individual signing NAVIN SANGOI
Valid signature Filed with authorized/valid electronic signature
CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2010 060986747 2011-05-16 CHARTER OAK HEALTH CENTER 109
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8605507500
Plan sponsor’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541

Plan administrator’s name and address
Administrator’s EIN 060986747
Plan administrator’s name CHARTER OAK HEALTH CENTER
Plan administrator’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541
Administrator’s telephone number 8605507500

Signature of
Role Plan administrator
Date 2011-05-16
Name of individual signing THOMAS MORRISON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-16
Name of individual signing THOMAS MORRISON
Valid signature Filed with authorized/valid electronic signature
CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2009 060986747 2010-10-04 CHARTER OAK HEALTH CENTER 92
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8605507500
Plan sponsor’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541

Plan administrator’s name and address
Administrator’s EIN 060986747
Plan administrator’s name CHARTER OAK HEALTH CENTER
Plan administrator’s address 21 GRAND ST STE 1, HARTFORD, CT, 061061541
Administrator’s telephone number 8605507500

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing THOMAS MORRISON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-04
Name of individual signing THOMAS MORRISON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
WINSHIP SERVICE CORPORATION Agent

Officer

Name Role Business address Residence address
Liany Arroyo Officer No data 21 Grand St, Hartford, CT, 06106-1541, United States
Rick Markello Officer No data 21 Grand St, Hartford, CT, 06106-1541, United States
Timothy Powers Officer 21 GRAND STREET, HARTFORD, CT, 06106, United States 22 Pleasant Street, F, Enfield, CT, 06082, United States
Kimberly Evans Officer No data 8 Shady Ln, West Hartford, CT, 06117, United States

Director

Name Role Residence address
Lolita Young Director 118 Main Street, Hartford, CT, 06106, United States
Anita Varunes Director 21 Grand Street, Hartford, CT, 06106, United States
Claudius McNish Director 170 Sisson Ave, 305, Hartford, CT, 06105-4033, United States
Nathan Berrios Director 21 Grand St, Hartford, CT, 06106-1541, United States
Veronica Barcelona Director 21 Grand st, Hartford, CT, 06106, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CSW.0005302 WHOLESALER OF DRUGS, COSMETICS & MEDICAL DEVICES ACTIVE CURRENT 2023-08-29 2024-07-01 2025-06-30
OPC.0001182 Outpatient Clinic ACTIVE CURRENT 2022-04-28 2022-04-28 2025-03-31
OPC.0001183 Outpatient Clinic ACTIVE CURRENT 2022-04-28 2022-04-28 2025-03-31
SA.0000512 Substance Abuse ACTIVE CURRENT 2016-08-29 2024-01-01 2025-12-31
OPC.0000654 Outpatient Clinic CLOSED CLOSED 2012-05-03 2012-03-28 2016-03-31
POCA.0000486 Psychiatric Outpatient Clinic CLOSED CLOSED 2010-10-28 2010-10-28 2014-09-30
POCA.0000395 Psychiatric Outpatient Clinic ACTIVE CURRENT 2010-01-01 2022-01-01 2024-12-31
OPC.0000259 Outpatient Clinic ACTIVE CURRENT 2009-07-01 2024-07-01 2027-06-30
OPC.0000312 Outpatient Clinic CLOSED CLOSED 2009-01-01 2009-01-01 2012-12-31
OPC.0000491 Outpatient Clinic CLOSED CLOSED 2008-12-31 2008-12-31 2011-12-31

History

Type Old value New value Date of change
Name change CHARTER OAK TERRACE/RICE HEIGHTS HEALTH CENTER, INC. CHARTER OAK HEALTH CENTER, INC. 2002-05-22
Name change CHARTER OAK TERRACE HEALTH CENTER, INC. CHARTER OAK TERRACE/RICE HEIGHTS HEALTH CENTER, INC. 1985-12-16

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012048523 2024-04-17 No data Annual Report Annual Report No data
BF-0011086447 2023-05-09 No data Annual Report Annual Report No data
BF-0010300256 2022-04-22 No data Annual Report Annual Report 2022
BF-0009756747 2021-11-17 No data Annual Report Annual Report No data
0006911602 2020-05-27 No data Annual Report Annual Report 2020
0006540015 2019-04-23 No data Annual Report Annual Report 2019
0006294973 2018-12-18 No data Annual Report Annual Report 2018
0005851834 2017-05-30 No data Annual Report Annual Report 2017
0005548761 2016-04-25 No data Annual Report Annual Report 2016
0005362481 2015-07-09 No data Annual Report Annual Report 2015

Related by officers

Rick Markello

CHARTER OAK HEALTH CENTER REALTY CORPORATION

Timothy Powers

T&T Home Improvement LLC WALL INDUSTRIES, INC.

Kimberly Evans

Black, Beauty, and Butterflies Inc. CHARTER OAK HEALTH CENTER REALTY CORPORATION

Veronica Barcelona

CHARTER OAK HEALTH CENTER REALTY CORPORATION

Related by address

21 GRAND STREET, HARTFORD, CT, 06106, United States

CHARTER OAK HEALTH CENTER REALTY CORPORATION

Date of last update: 06 Jan 2025

Sources: Connecticut's Official State Website

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