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COMMUNITY CARE OF KENTUCKY, INC.

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Company Details

Name: COMMUNITY CARE OF KENTUCKY, INC.
Legal type: Kentucky Corporation
Status: Inactive
Standing: Bad
Profit or Non-Profit: Non-profit
File Date: 04 Mar 2014 (11 years ago)
Organization Date: 04 Mar 2014 (11 years ago)
Last Annual Report: 28 Jun 2023 (2 years ago)
Organization Number: 0880976
Principal Office: 465 MEDFORD STREET, BOSTON, MA 02129-1454
Place of Formation: KENTUCKY

Director

Name Role
JEFFREY A. PARKER Director
BRIAN NOVY Director
TEQUILA TERRY Director
Denise Marks Director
Myechia Minter-Jordan Director
Grandy Cody Director

Incorporator

Name Role
ROSS D. COHEN Incorporator

Registered Agent

Name Role
CORPORATION SERVICE COMPANY Registered Agent

Executive

Name Role
Gregory Winn Executive

President

Name Role
Myechia Minter-Jordan President

Secretary

Name Role
Patricia Ma Secretary

Treasurer

Name Role
Denise Marks Treasurer

National Provider Identifier

NPI Number:
1811375785

Authorized Person:

Name:
JENELL STUMP
Role:
MANAGER, LICENSING & CREDENTIALING
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
2562411698
Fax:
5027782301

Assumed Names

Name Status Expiration Date
COMMUNITY DENTAL CARE Inactive 2021-06-28
COMMUNITY DENTAL Inactive 2019-08-26

Filings

Name File Date
Administrative Dissolution 2024-10-12
Annual Report 2023-06-28
Annual Report 2022-05-04
Registered Agent name/address change 2021-10-05
Annual Report 2021-05-24

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Sources: Kentucky Secretary of State