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Legacy Health Clinic, LLC

Contents

Company Details

Name: Legacy Health Clinic, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 31 Aug 2015 (9 years ago)
Entity Number: 10031822
ZIP code: 99901
County: Ketchikan Gateway
Place of Formation: ALASKA
Address: 3524 TONGASS AVENUE, KETCHIKAN, AK 99901

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621498 ALL OTHER OUTPATIENT CARE CENTERS

Officers

Name Role
Jessica Pilcher Member
Helen Klein Member
AA Northwest Registered Agent, Inc. Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
LEGACY HEALTH CLINIC 401(K) PLAN 2023 474942987 2024-08-29 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Sponsor LEGACY HEALTH CLINIC, LLC
Business code 621399
Sponsor’s telephone number 9072256355
Plan sponsor’s address 3524 TONGASS AVENUE, KETCHIKAN, AK, 99901

Signature of

Role Plan administrator
Date 2024-08-29
Name of individual signing JESSICA PILCHER
LEGACY HEALTH CLINIC 401(K) PLAN 2022 474942987 2023-08-15 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Sponsor LEGACY HEALTH CLINIC, LLC
Business code 621399
Sponsor’s telephone number 9072256355
Plan sponsor’s address 3524 TONGASS AVENUE, KETCHIKAN, AK, 99901

Signature of

Role Plan administrator
Date 2023-08-15
Name of individual signing JESSICA PILCHER
LEGACY HEALTH CLINIC 401(K) PLAN 2021 474942987 2022-07-01 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Sponsor LEGACY HEALTH CLINIC, LLC
Business code 621399
Sponsor’s telephone number 9072256355
Plan sponsor’s address 3524 TONGASS AVENUE, KETCHIKAN, AK, 99901

Signature of

Role Plan administrator
Date 2022-07-01
Name of individual signing HELEN KLEIN

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 1026024 Active 2015-09-04 2022-10-07 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS
Telemedicine Business Registry 158783 Active 2020-03-13 - - -

Date of last update: 10 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development