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Bluegrass Behavioral Health Group, LLC

Headquarter

Company Details

Name: Bluegrass Behavioral Health Group, LLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 29 Nov 2016 (8 years ago)
Organization Date: 29 Nov 2016 (8 years ago)
Last Annual Report: 31 May 2024 (8 months ago)
Managed By: Members
Organization Number: 0969256
Industry: Health Services
Number of Employees: Large (100+)
Principal Office: 1272 Bond Street, Suite 100 , Naperville, IL 60563
Place of Formation: KENTUCKY

Links between entities

Type Company Name Company Number State
Headquarter of Bluegrass Behavioral Health Group, LLC, FLORIDA M20000004107 FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUEGRASS BEHAVIORAL HEALTH GROUP 401(K) PLAN 2023 814542291 2024-05-08 BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 541600
Sponsor’s telephone number 8593603006
Plan sponsor’s address 925 DUDLEY RD., EDGEWOOD, KY, 41017

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 2024-05-08
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS BEHAVIORAL HEALTH GROUP 401(K) PLAN 2022 814542291 2023-06-22 BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 541600
Sponsor’s telephone number 8593603006
Plan sponsor’s address 925 DUDLEY RD., EDGEWOOD, KY, 41017

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 2023-06-22
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS BEHAVIORAL HEALTH GROUP 401(K) PLAN 2021 814542291 2022-10-14 BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC 87
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 541600
Sponsor’s telephone number 8593603006
Plan sponsor’s address 925 DUDLEY RD., EDGEWOOD, KY, 41017

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS BEHAVIORAL HEALTH GROUP 401(K) PLAN 2020 814542291 2021-07-16 BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC 57
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 541600
Sponsor’s telephone number 8593603006
Plan sponsor’s address 925 DUDLEY RD., EDGEWOOD, KY, 41017

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS BEHAVIORAL HEALTH GROUP 401(K) PLAN 2019 814542291 2020-09-25 BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 541600
Sponsor’s telephone number 8593603006
Plan sponsor’s address 925 DUDLEY RD., EDGEWOOD, KY, 41017

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-09-24
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS BEHAVIORAL HEALTH GROUP RETIREMENT TRUST 2019 814542291 2020-07-31 BLUEGRASS BEHAVIORAL HEALTH GROUP 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541600
Sponsor’s telephone number 8596200041
Plan sponsor’s address 6272 WOODCREST DRIVE, BURLINGTON, KY, 41005

Signature of
Role Plan administrator
Date 2020-07-31
Name of individual signing BRETT BLEVINS
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS BEHAVIORAL HEALTH GROUP RETIREMENT TRUST 2018 814542291 2019-06-28 BLUEGRASS BEHAVIORAL HEALTH GROUP 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541600
Sponsor’s telephone number 8596200041
Plan sponsor’s address 6272 WOODCREST DRIVE, BURLINGTON, KY, 41005

Signature of
Role Plan administrator
Date 2019-06-28
Name of individual signing BRETT BLEVINS
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
CT CORPORATION SYSTEM Registered Agent
Brett Blevins Registered Agent

Member

Name Role
Cultivate Behavioral Management Corp. Member

Organizer

Name Role
Brett Blevins Organizer

Assumed Names

Name Status Expiration Date
CULTIVATE BEHAVIORAL HEALTH & EDUCATION Active 2025-10-01

Filings

Name File Date
Annual Report 2024-05-31
Annual Report 2023-04-10
Principal Office Address Change 2023-04-10
Annual Report 2022-03-07
Principal Office Address Change 2021-05-21
Annual Report 2021-05-21
Registered Agent name/address change 2021-02-01
Certificate of Assumed Name 2020-09-24
Registered Agent name/address change 2020-05-27
Principal Office Address Change 2020-05-27

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Brett Blevins

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Related by address

No related companies by address

Date of last update: 12 Jan 2025

Sources: Kentucky Secretary of State

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