| Entity Name: | AVANTA CLINIC LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 15 Feb 2018 |
| Business ALEI: | 1264010 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Business address: | 131 NEW LONDON TPKE SUITE 105, GLASTONBURY, CT, 06033, United States |
| Mailing address: | 131 NEW LONDON TPKE SUITE 105, GLASTONBURY, CT, United States, 06033 |
| ZIP code: | 06033 |
| County: | Hartford |
| Place of Formation: | CONNECTICUT |
| E-Mail: | sudeepbansal@avantaclinic.com |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AVANTA CLINIC LLC 401(K) PLAN | 2023 | 824388776 | 2024-04-30 | AVANTA CLINIC LLC | 6 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-04-30 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8604305599 |
| Plan sponsor’s address | 131 NEW LONDON TURNPIKE, STE 105, GLASTONBURY, CT, 06033 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-27 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Mailing address | Phone | Residence address | |
|---|---|---|---|---|---|---|
| SUDEEP BANSAL | Agent | 131 NEW LONDON TPKE, STE 105, GLASTONBURY, CT, 06033, United States | 131 NEW LONDON TPKE, STE 105, GLASTONBURY, CT, 06033, United States | +1 860-990-9703 | sudeepbansal@avantaclinic.com | 281 JONES STREET, AMSTON, CT, 06231, United States |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| SUDEEP BANSAL | Officer | 131 NEW LONDON TPKE, STE 105, GLASTONBURY, CT, 06033, United States | +1 860-990-9703 | sudeepbansal@avantaclinic.com | 281 JONES STREET, AMSTON, CT, 06231, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012194055 | 2024-01-12 | No data | Annual Report | Annual Report | No data |
| BF-0011349677 | 2023-01-12 | No data | Annual Report | Annual Report | No data |
| BF-0010265048 | 2022-02-01 | No data | Annual Report | Annual Report | 2022 |
| 0007086067 | 2021-01-28 | No data | Annual Report | Annual Report | 2021 |
| 0006754229 | 2020-02-12 | No data | Annual Report | Annual Report | 2020 |
| 0006304869 | 2019-01-03 | No data | Annual Report | Annual Report | 2019 |
| 0006180196 | 2018-05-09 | 2018-05-09 | Change of Business Address | Business Address Change | No data |
| 0006089456 | 2018-02-15 | 2018-02-15 | Business Formation | Certificate of Organization | No data |
Date of last update: 13 Jan 2025
Sources: Connecticut's Official State Website
