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  5. ANCORA HOME HEALTH AND HOSPICE LLC

ANCORA HOME HEALTH AND HOSPICE LLC

Contents

Company Details

Name: ANCORA HOME HEALTH AND HOSPICE LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 18 Jan 2018 (7 years ago)
Entity Number: 10076246
ZIP code: 99654
County: Matanuska Susitna
Place of Formation: ALASKA
Address: 3831 EAST BLUE LUPINE DRIVE, WASILLA, AK 99654
Mailing Address: 350 EAST 2200 NORTH, NORTH LOGAN, UT 84341

Officers

Name Role
The Osirus Group Manager
Mangum, Inc. Manager
MARK JORGENSEN PT PC Member
Mangum, Inc. Member
The Osirus Group Member
Nicholas Larsen Registered Agent

Unique Entity ID

Unique Entity ID Expiration Date Physical Address
L6DXKW8MW7U1 2022-12-08 2851 E PALMER WASILLA HWY STE 7, WASILLA, AK, 99654, 7499, USA
Mailing Address 2851 E PALMER WASILLA HWY STE 7, WASILLA, AK, 99654, 7499, USA

Business Information
Division Name ANCORA HOME HEALTH AND HOSPICE
Division Number ANCORA HOM
Congressional District 00
State/Country of Incorporation AK, USA
Activation Date 2021-11-09
Initial Registration Date 2020-11-17
Entity Start Date 2018-09-01
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name SANDY MORGAN
Role MANAGER
Address 258 S MAIN ST, 210, LOGAN, UT, 84321, USA
Government Business
Title PRIMARY POC
Name SANDY MORGAN
Role MANAGER
Address 258 S MAIN ST, 210, LOGAN, UT, 84321, USA
Past Performance -

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
RETIREMENT INCOME SECURITY PLAN-ANCORA HOME HEALTH AND HOSPICE LLC 2021 824062977 2022-11-28 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Sponsor ANCORA HOME HEALTH AND HOSPICE LLC
Business code 623000
Sponsor’s telephone number 9075619240
Plan sponsor’s address 2851 EAST PALMER WASILLA HWY, SUITE 7, WASILLA, AK, 99654

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2022-11-28
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-ANCORA HOME HEALTH AND HOSPICE LLC 2021 824062977 2022-07-26 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Sponsor ANCORA HOME HEALTH AND HOSPICE LLC
Business code 623000
Sponsor’s telephone number 9075619240
Plan sponsor’s address 2851 EAST PALMER WASILLA HWY, SUITE 7, WASILLA, AK, 99654

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing STEVEN STOUT
RETIREMENT INCOME SECURITY PLAN-ANCORA HOME HEALTH AND HOSPICE LLC 2020 824062977 2021-07-22 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Sponsor ANCORA HOME HEALTH AND HOSPICE LLC
Business code 623000
Sponsor’s telephone number 9075619240
Plan sponsor’s address 2851 EAST PALMER WASILLA HWY, SUITE 7, WASILLA, AK, 99654

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing STEVEN STOUT
ANCORA HOME HEALTH AND HOSPICE 401(K) PLAN 2019 824062977 2020-10-14 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Sponsor ANCORA HOME HEALTH AND HOSPICE
Business code 623000
Sponsor’s telephone number 9073524800
Plan sponsor’s address 950 E. BOGARD, SUITE 132, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing CHAD MAGUM
ANCORA HOME HEALTH AND HOSPICE 401(K) PLAN 2018 824062977 2019-10-03 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-10-01
Sponsor ANCORA HOME HEALTH AND HOSPICE
Business code 623000
Sponsor’s telephone number 9073524800
Plan sponsor’s address 950 E. BOGARD, SUITE 132, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2019-10-03
Name of individual signing CHAD MAGUM

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Telemedicine Business Registry 180979 Active 2021-07-19 - - -

Date of last update: 10 Jan 2025

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

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