| Name: | LIFESKILLS HEALTH SERVICES, INC. |
| Jurisdiction: | Kentucky |
| Profit or Non-Profit: | Non-profit |
| Legal type: | Kentucky Corporation |
| Status: | Active |
| Standing: | Good |
| File Date: | 18 Feb 2016 (9 years ago) |
| Organization Date: | 18 Feb 2016 (9 years ago) |
| Last Annual Report: | 30 Jul 2024 (6 months ago) |
| Organization Number: | 0939213 |
| ZIP code: | 42101 |
| Primary County: | Warren |
| Principal Office: | 330 E. 10TH AVENUE, BOWLING GREEN, KY 42101 |
| Place of Formation: | KENTUCKY |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LIFEHEALTH SERVICES, INC. FRINGE BENEFIT PLAN | 2023 | 811641498 | 2024-05-09 | LIFESKILLS HEALTH SERVICES, INC. | 302 | |||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||
| Active participants | 233 |
| Other retired or separated participants entitled to future benefits | 15 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-03 |
| Name of individual signing | JOHN SIVLEY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2018-01-01 |
| Business code | 621330 |
| Sponsor’s telephone number | 2709015000 |
| Plan sponsor’s mailing address | 330 EAST 10TH AVE, PO BOX 9500, BOWLING GREEN, KY, 421029500 |
| Plan sponsor’s address | 330 EAST 10TH AVE, PO BOX 9500, BOWLING GREEN, KY, 421029500 |
Number of participants as of the end of the plan year
| Active participants | 293 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-13 |
| Name of individual signing | JOHN SIVLEY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-06-13 |
| Name of individual signing | JOHN SIVLEY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| DAVID F. BRODERICK | Registered Agent |
| Name | Role |
|---|---|
| John O. Sivley | CEO |
| Name | Role |
|---|---|
| Rick DuBose | Director |
| Clarence Gamble | Director |
| John Eaton | Director |
| Randall Curry | Director |
| DAVID F BRODERICK | Director |
| JOE DAN BEAVERS | Director |
| CLARENCE GAMBLE | Director |
| Name | Role |
|---|---|
| DAVID F BRODERICK | Incorporator |
| Name | Action |
|---|---|
| LIFESKILLS HEALTH SERVICES, INC. | Type Conversion |
| Name | Status | Expiration Date |
|---|---|---|
| LIFEHEALTH SERVICE | Inactive | 2023-12-28 |
| Name | File Date |
|---|---|
| Annual Report | 2024-07-30 |
| Annual Report | 2023-03-20 |
| Principal Office Address Change | 2023-03-20 |
| Annual Report | 2022-03-31 |
| Annual Report | 2021-02-11 |
| Annual Report | 2020-03-04 |
| Annual Report | 2019-04-03 |
| Certificate of Assumed Name | 2018-12-28 |
| Principal Office Address Change | 2018-11-15 |
| Annual Report | 2018-05-09 |
Date of last update: 12 Jan 2025
Sources: Kentucky Secretary of State
