| Entity Name: | MATULAITIS NURSING HOME, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Non-Stock |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report past due |
| Date Formed: | 30 Jun 1978 |
| Business ALEI: | 0077199 |
| Annual report due: | 30 Jun 2024 |
| NAICS code: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Business address: | 10 THURBER ROAD, PUTNAM, CT, 06260, United States |
| Mailing address: | 10 THURBER ROAD, PUTNAM, CT, United States, 06260 |
| ZIP code: | 06260 |
| County: | Windham |
| Place of Formation: | CONNECTICUT |
| E-Mail: | lryan@matulaitisnh.org |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATULAITIS NURSING HOME, INC. RETIREMENT PLAN | 2023 | 060983700 | 2024-06-18 | MATULAITIS NURSING HOME, INC. | 156 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-06-18 |
| Name of individual signing | JOHN IOVIENO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| JOHN IOVIENO | Agent | 10 THURBER ROAD, PUTNAM, CT, 06260, United States | +1 860-395-4833 | jiovieno@matulaitisnh.org | 200 GRAPEVINE ROAD, HIGGANUM, CT, 06441, United States |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| JOHN IOVIENO | Director | 10 THURBER RD, PUTNAM, CT, 06260, United States | +1 860-395-4833 | jiovieno@matulaitisnh.org | 200 GRAPEVINE ROAD, HIGGANUM, CT, 06441, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| CCNH.000989C | Chronic & Convalescent Nursing Home | ACTIVE IN RENEWAL | CURRENT | 2010-01-01 | 2022-01-01 | 2023-12-31 |
| NATP.000044-CCNH | Nurse Aide Training Program-Nursing Home | INACTIVE | LAPSED DUE TO NON-RENEWAL | 1990-07-12 | 1990-07-12 | 2011-05-08 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0011085279 | 2024-04-29 | No data | Annual Report | Annual Report | No data |
| BF-0010255726 | 2024-04-29 | No data | Annual Report | Annual Report | 2022 |
| BF-0011932482 | 2023-08-15 | 2023-08-15 | Amendment | Certificate of Amendment | No data |
| BF-0010446562 | 2022-02-10 | 2022-02-10 | Change of Agent | Business Address Change | No data |
| BF-0010103883 | 2021-08-02 | 2021-08-02 | Amendment | Certificate of Amendment | No data |
| BF-0009753755 | 2021-06-30 | No data | Annual Report | Annual Report | No data |
| 0007217401 | 2021-03-10 | No data | Annual Report | Annual Report | 2019 |
| 0007217413 | 2021-03-10 | No data | Annual Report | Annual Report | 2020 |
| 0006241947 | 2018-09-05 | 2018-09-05 | Change of Agent | Agent Change | No data |
| 0006181324 | 2018-05-10 | No data | Annual Report | Annual Report | 2018 |
Date of last update: 20 Jan 2025
Sources: Connecticut's Official State Website
