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  5. COMMUNITY FAMILY CLINIC, PLLC

COMMUNITY FAMILY CLINIC, PLLC

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Company Details

Name: COMMUNITY FAMILY CLINIC, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 28 Mar 2006 (19 years ago)
Organization Date: 28 Mar 2006 (19 years ago)
Last Annual Report: 25 Mar 2024 (a year ago)
Managed By: Members
Organization Number: 0635519
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 40322
City: Frenchburg, Mariba, Scranton
Primary County: Menifee County
Principal Office: 784 HWY 36, FRENCHBURG, KY 40322
Place of Formation: KENTUCKY

Organizer

Name Role
TAUFIK KASSIS Organizer

Registered Agent

Name Role
TAUFIK KASSIS Registered Agent

Member

Name Role
TAUFIK KASSIS Member

U.S. Small Business Administration Profile

Phone Number:
606-768-9190
E-mail Address:
Shaneiceta.Rupe@cfamilyclinic.com
Fax Number:
606-768-9180
Contact Person:
SHANEICETA RUPE
User ID:
P0760328

Unique Entity ID

Unique Entity ID:
KB5JG56PBPU9
CAGE Code:
4DJB3
UEI Expiration Date:
2025-10-29

Business Information

Division Name:
COMMUNITY FAMILY CLINIC, PLLC
Activation Date:
2024-10-31
Initial Registration Date:
2006-04-19

Commercial and government entity program

CAGE number:
4DJB3
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-10-31
CAGE Expiration:
2029-10-31
SAM Expiration:
2025-10-29

Contact Information

POC:
SHANEICETA RUPE

National Provider Identifier

NPI Number:
1518302892
Certification Date:
2023-07-20
Link:
View on NPI website

Authorized Person:

Name:
TAUFIK KASSIS
Role:
OWNER
Phone:
6067689190

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Phone:
+1 606-768-9190
Phone:
+1 606-674-3033

Form 5500 Series

Employer Identification Number (EIN):
204608382
Plan Year:
2024
Number Of Participants:
65
Sponsors Telephone Number:
6067689190
File:
View File
Plan Year:
2023
Number Of Participants:
36
Sponsors Telephone Number:
6067689190
File:
View File
Plan Year:
2022
Number Of Participants:
49
Sponsors Telephone Number:
6067689190
File:
View File
Plan Year:
2021
Number Of Participants:
42
Sponsors Telephone Number:
6067689190
File:
View File
Plan Year:
2020
Number Of Participants:
47
Sponsors Telephone Number:
6067689190

Filings

Name File Date
Annual Report 2024-03-25
Annual Report 2023-05-02
Annual Report 2022-04-20
Annual Report 2021-04-06
Annual Report 2020-03-25

USAspending Awards / Contracts

Procurement Instrument Identifier:
1282A723C0007
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DEFINITIVE CONTRACT
Action Obligation:
99456.00
Base And Exercised Options Value:
99456.00
Base And All Options Value:
0.00
Awarding Agency Name:
Department of Agriculture
Performance Start Date:
2022-11-01
Description:
MEDICAL SERVICES; FRENCHBURG JOB CORP CENTER; FRENCHBURG, KY; EXERCISE OPTION YEAR 2
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- MANAGED HEALTHCARE
Procurement Instrument Identifier:
1282A718C0005
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DEFINITIVE CONTRACT
Action Obligation:
73600.00
Base And Exercised Options Value:
73600.00
Base And All Options Value:
372000.00
Awarding Agency Name:
Department of Agriculture
Performance Start Date:
2017-11-01
Description:
MEDICAL SERVICES; FRENCHBURG JOB CORPS CENTER; FRENCHBURG, KY
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE
Procurement Instrument Identifier:
AG82A7C130004
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DEFINITIVE CONTRACT
Action Obligation:
70278.00
Base And Exercised Options Value:
70278.00
Base And All Options Value:
70278.00
Awarding Agency Name:
Department of Agriculture
Performance Start Date:
2012-10-30
Description:
IGF::CT::IGF PHYSICIAN SERVICES FOR FRENCHBURG JOB CORPS CCC
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE

USAspending Awards / Financial Assistance

Date:
2021-07-20
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL HEALTH CLINIC VACCINE CONFIDENCE PROGRAM
Obligated Amount:
39758.03
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-03-23
Link:
View on USAspending
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:
449900.00
Total Face Value Of Loan:
449900.00
Date:
2020-04-07
Link:
View on USAspending
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:
413900.00
Total Face Value Of Loan:
413800.00

Paycheck Protection Program

Jobs Reported:
44
Initial Approval Amount:
$449,900
Date Approved:
2021-03-23
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$449,900
Race:
White
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$452,291.25
Servicing Lender:
Traditional Bank, Inc.
Use of Proceeds:
Payroll: $449,898
Utilities: $1
Jobs Reported:
40
Initial Approval Amount:
$413,900
Date Approved:
2020-04-03
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$413,800
Race:
White
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$416,940.35
Servicing Lender:
Traditional Bank, Inc.
Use of Proceeds:
Payroll: $413,800

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Government Spending

Branch Date of Service Fiscal Year Cabinet Department Classification Item Name Amount
Executive 2024-12-19 2025 Health & Family Services Cabinet Department For Community Based Services Non Pro Contract Lab Tests & Anal Fees 1099 Rep 50
Executive 2023-09-25 2024 Health & Family Services Cabinet Department For Community Based Services Non Pro Contract Lab Tests & Anal Fees 1099 Rep 75
Executive 2023-08-31 2024 Health & Family Services Cabinet Department For Community Based Services Non Pro Contract Lab Tests & Anal Fees 1099 Rep 50

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Sources: Kentucky Secretary of State

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