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Buena Vida ADHC, LLC

Company Details

Name: Buena Vida ADHC, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 30 Apr 2019 (6 years ago)
Organization Date: 30 Apr 2019 (6 years ago)
Last Annual Report: 18 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 1057050
Industry: Health Services
Number of Employees: Large (100+)
ZIP code: 40213
City: Louisville, Audubon Park, Lynnview, Poplar Hills
Primary County: Jefferson County
Principal Office: 4620 Preston Hwy, Louisville, KY 40213
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BUENA VIDA ADHC CBS BENEFIT PLAN 2023 834582522 2024-12-30 BUENA VIDA ADHC 16
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-07-01
Business code 624200
Sponsor’s telephone number 5022909014
Plan sponsor’s address 4620 PRESTON HWY, LOUISVILLE, KY, 40213

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name JOSEPH HSU
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2024-12-30
Name of individual signing JOSEPH HSU
Valid signature Filed with authorized/valid electronic signature
BUENA VIDA ADHC CBS BENEFIT PLAN 2022 834582522 2023-12-27 BUENA VIDA ADHC 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-07-01
Business code 624200
Sponsor’s telephone number 5022909014
Plan sponsor’s address 4620 PRESTON HWY, LOUISVILLE, KY, 40213

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2023-12-27
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
BUENA VIDA ADHC CBS BENEFIT PLAN 2021 834582522 2022-12-29 BUENA VIDA ADHC 9
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-07-01
Business code 624200
Sponsor’s telephone number 5022909014
Plan sponsor’s address 4620 PRESTON HWY, LOUISVILLE, KY, 40213

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2022-12-29
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
BUENA VIDA ADHC LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 834582522 2022-04-08 BUENA VIDA ADHC 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 624410
Sponsor’s telephone number 5022981455
Plan sponsor’s address 4620 PRESTON HWY, LOUISVILLE, KY, 40213

Signature of

Role Plan administrator
Date 2022-04-08
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature

Organizer

Name Role
james babbitz Organizer

Member

Name Role
Yarima Elena Hernandez Perez Member

Registered Agent

Name Role
Yarima Elena Hernandez Perez Registered Agent

Filings

Name File Date
Annual Report 2025-02-18
Registered Agent name/address change 2024-03-24
Annual Report 2024-03-24
Annual Report 2023-03-21
Annual Report 2022-05-31
Annual Report 2021-04-15
Annual Report 2020-07-14

Motor Carrier Census

USDOT Number Carrier Operation MCS-150 Form Date MCS-150 Mileage MCS-150 Year Power Units Drivers Operation Classification
3379980 Intrastate Non-Hazmat 2023-01-02 - - 0 8 Exempt For Hire
Legal Name BUENA VIDA ADHC LLC
DBA Name -
Physical Address 4620 PRESTON HWY, LOUISVILLE, KY, 40213-2146, US
Mailing Address 4620 PRESTON HWY, LOUISVILLE, KY, 40213-2146, US
Phone (502) 298-1455
Fax (502) 891-0028
E-mail BUENAVIDAKY@YAHOO.COM

Safety Measurement System - All Transportation

Total Number of Inspections for the measurement period (24 months) 0
Driver Fitness BASIC Serious Violation Indicator No
Vehicle Maintenance BASIC Acute/Critical Indicator No
Unsafe Driving BASIC Acute/Critical Indicator No
Driver Fitness BASIC Roadside Performance measure value 0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value 0
Total Number of Driver Inspections for the measurment period 0
Vehicle Maintenance BASIC Roadside Performance measure value 0
Total Number of Vehicle Inspections for the measurement period 0
Controlled Substances and Alcohol BASIC Roadside Performance measure value 0
Unsafe Driving BASIC Roadside Performance Measure Value 0
Number of inspections with at least one Driver Fitness BASIC violation 0
Number of inspections with at least one Hours-of-Service BASIC violation 0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation 0
Number of inspections with at least one Vehicle Maintenance BASIC violation 0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation 0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation 0
Number of inspections with at least one Unsafe Driving BASIC violation 0

Sources: Kentucky Secretary of State