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CALVERT CITY CONVALESCENT CENTER, INC.

Company Details

Name: CALVERT CITY CONVALESCENT CENTER, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 31 Aug 1971 (54 years ago)
Organization Date: 31 Aug 1971 (54 years ago)
Last Annual Report: 08 Jan 2025 (5 months ago)
Organization Number: 0007285
Industry: Health Services
Number of Employees: Large (100+)
ZIP code: 42029
City: Calvert City
Primary County: Marshall County
Principal Office: 1201 EAST 5TH AVENUE, CALVERT CITY, KY 42029
Place of Formation: KENTUCKY

Registered Agent

Name Role
MRS. KEM COTHRAN Registered Agent

Incorporator

Name Role
LELAND DIETSCH Incorporator
REV. JEROME BROWNE Incorporator
CHARLES R. HINES Incorporator
DANDRIDGE F. WALTON Incorporator
DR. CARROLL TRAYLOR Incorporator

Secretary

Name Role
Tina Muir Secretary

Treasurer

Name Role
Tina Muir Treasurer

Vice President

Name Role
Sandy David Vice President

Director

Name Role
Kay Travis Director
Tina Johnson Director
Kem Cothran Director
Sandy David Director
Terri Bailey Director
Karen Owen Director
Chris Freeland Director
J. B. CONN Director
JIM FERN Director
DR. RICHARD COLBURN Director

President

Name Role
Kem Cothran President

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
SHRXTBWUF3H7
CAGE Code:
9XEL0
UEI Expiration Date:
2026-03-21

Business Information

Doing Business As:
CALVERT CITY NURSING AND REHAB
Division Name:
CALVERT CITY CONVALESCENCE CENTER, INC
Activation Date:
2025-03-25
Initial Registration Date:
2024-06-06

National Provider Identifier

NPI Number:
1588650618

Authorized Person:

Name:
MRS. LAURIE M TRAVIS
Role:
ASST BUSINESS ADMN
Phone:

Taxonomy:

Selected Taxonomy:
313M00000X - Nursing Facility/Intermediate Care Facility
Is Primary:
Yes

Contacts:

Fax:
2703954962

Form 5500 Series

Employer Identification Number (EIN):
610727805
Plan Year:
2023
Number Of Participants:
65
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
65
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
64
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
84
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
87
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
CALVERT CITY NURSING AND REHAB Active 2027-12-05

Filings

Name File Date
Annual Report 2025-01-08
Annual Report 2024-02-28
Registered Agent name/address change 2024-02-28
Annual Report 2023-03-17
Certificate of Assumed Name 2022-12-05

USAspending Awards / Financial Assistance

Date:
2020-04-27
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
660200.00
Total Face Value Of Loan:
660200.00

OSHA's Inspections within Industry

Inspection Summary

Date:
2005-12-01
Type:
Planned
Address:
1201 5TH AVE, CALVERT CITY, KY, 42029
Safety Health:
Health
Scope:
Complete

Tax Exempt

Employer Identification Number (EIN) :
61-0727805
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
1979-08
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
660200
Current Approval Amount:
660200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
663537.68

Sources: Kentucky Secretary of State