| Entity Name: | RIDGEFIELD SURGICAL CENTER, LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Dissolved |
| Date Formed: | 15 Mar 2004 |
| Date of dissolution: | 17 Apr 2014 |
| Business ALEI: | 0778112 |
| Business address: | 24 HOSPITAL AVE, DANBURY, CT, 06810 |
| Mailing address: | ATTN: LEGAL DEPT.WY 24 HOSPITAL AVE, DANBURY, CT, 06810 |
| ZIP code: | 06810 |
| County: | Fairfield |
| Place of Formation: | CONNECTICUT |
| E-Mail: | kim.skerencak@danhosp.org |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | RIDGEFIELD SURGICAL CENTER, LLC, NEW YORK | 3895328 | NEW YORK |
| CIK number | Mailing Address | Business Address | Phone | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1310007 | 107 NEWTOWN ROAD, SUITE 28, DANBURY, CT, 06810 | 107 NEWTOWN ROAD, SUITE 28, DANBURY, CT, 06810 | 2038304700 | |||||||||||||||||||||||||||||||||||||||||
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| Form type | D |
| File number | 021-71483 |
| Filing date | 2009-11-25 |
| File | View File |
Filings since 2006-08-14
| Form type | REGDEX |
| File number | 021-71483 |
| Filing date | 2006-08-14 |
| File | View File |
Filings since 2005-07-13
| Form type | REGDEX/A |
| File number | 021-71483 |
| Filing date | 2005-07-13 |
| File | View File |
Filings since 2005-05-11
| Form type | REGDEX/A |
| File number | 021-71483 |
| Filing date | 2005-05-11 |
| File | View File |
Filings since 2004-11-26
| Form type | REGDEX |
| File number | 021-71483 |
| Filing date | 2004-11-26 |
| File | View File |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RIDGEFIELD SURGICAL CENTER, LLC 401(K) PLAN | 2011 | 201319996 | 2012-10-15 | RIDGEFIELD SURGICAL CENTER, LLC | 13 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 201319996 |
| Plan administrator’s name | RIDGEFIELD SURGICAL CENTER, LLC |
| Plan administrator’s address | 901 ETHAN ALLEN HIGHWAY, SUITE 105, RIDGEFIELD, CT, 06877 |
| Administrator’s telephone number | 2032442402 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-15 |
| Name of individual signing | KIM SKERENCAK |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-10-15 |
| Name of individual signing | KIM SKERENCAK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2032442402 |
| Plan sponsor’s address | 901 ETHAN ALLEN HIGHWAY, SUITE 105, RIDGEFIELD, CT, 06877 |
Plan administrator’s name and address
| Administrator’s EIN | 201319996 |
| Plan administrator’s name | RIDGEFIELD SURGICAL CENTER, LLC |
| Plan administrator’s address | 901 ETHAN ALLEN HIGHWAY, SUITE 105, RIDGEFIELD, CT, 06877 |
| Administrator’s telephone number | 2032442402 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-05 |
| Name of individual signing | KIM SKERENCAK |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-10-05 |
| Name of individual signing | KIM SKERENCAK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2032442402 |
| Plan sponsor’s address | 901 ETHAN ALLEN HIGHWAY, SUITE 105, RIDGEFIELD, CT, 06877 |
Plan administrator’s name and address
| Administrator’s EIN | 201319996 |
| Plan administrator’s name | RIDGEFIELD SURGICAL CENTER, LLC |
| Plan administrator’s address | 901 ETHAN ALLEN HIGHWAY, SUITE 105, RIDGEFIELD, CT, 06877 |
| Administrator’s telephone number | 2032442402 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-14 |
| Name of individual signing | KIM SKERANCEK |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-14 |
| Name of individual signing | KIM SKERANCEK |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| KAREN MATTEI | Agent | WESTERN CONNECTICUT NETWORK, INC., 24 HOSPITAL AVE, DANBURY, CT, 06810, United States | 38 DEER RUN ROAD, BROOKFIELD, CT, 06804, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| WESTERN CONNECTICUT HEALTH NETWORK, INC. | Officer | 24 HOSPITAL AVE, DANBURY, CT, 06810, United States | NONE, |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| ASC.0000294 | Out-Patient Surgical Facility | INACTIVE | VOLUNTARILY SURRENDERED | 2008-07-01 | 2010-07-01 | 2012-06-30 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| 0005088367 | 2014-04-17 | No data | Dissolution | Certificate of Dissolution | No data |
| 0005087238 | 2014-04-16 | No data | Amendment | Restate | No data |
| 0004561117 | 2011-05-04 | No data | Annual Report | Annual Report | 2011 |
| 0004143005 | 2010-04-14 | No data | Change of Agent | Agent Change | No data |
| 0004115809 | 2010-03-09 | No data | Annual Report | Annual Report | 2010 |
| 0003881052 | 2009-03-09 | No data | Annual Report | Annual Report | 2009 |
| 0003684598 | 2008-04-07 | No data | Annual Report | Annual Report | 2008 |
| 0003521012 | 2007-08-17 | No data | Annual Report | Annual Report | 2007 |
| 0003215989 | 2006-05-11 | No data | Amendment | Restate | No data |
| 0003206297 | 2006-04-18 | No data | Annual Report | Annual Report | 2006 |
Date of last update: 06 Jan 2025
Sources: Connecticut's Official State Website
