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  5. THE VALLEY HOSPITAL ASSOCIATION, INC.

THE VALLEY HOSPITAL ASSOCIATION, INC.

Contents

Company Details

Name: THE VALLEY HOSPITAL ASSOCIATION, INC.
Jurisdiction: Alaska
Legal type: Nonprofit Corporation
Status: Good Standing
Date of registration: 19 May 1952 (73 years ago)
Entity Number: 2378D
ZIP code: 99654
County: Matanuska Susitna
Place of Formation: ALASKA
Address: 777 N CRUSEY STREET, STE A201, WASILLA, AK 99654
Mailing Address: 777 N CRUSEY ST STE A201, WASILLA, AK 99654

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

622110 GENERAL MEDICAL AND SURGICAL HOSPITALS

Officers

Name Role
TERI NAMTVEDT Secretary
WILLIAM NEWCOMBE Director
TERI NAMTVEDT Treasurer
LEBRON MCPHAIL Director
GREG JONES Director
KEITH KEHOE Director
LISA WADE President
LISA WADE Director
RAELYNN DANIELOWSKI Director
SAMMYE POKRYFKI Director

Unique Entity ID

Unique Entity ID Expiration Date Physical Address
STACAEGKYTF6 2024-12-14 777 N CRUSEY ST STE A201, WASILLA, AK, 99654, 7104, USA
Mailing Address 777 N CRUSEY ST STE A201, WASILLA, AK, 99654, 7104, USA

Business Information
Doing Business As MAT-SU HEALTH FOUNDATION
URL www.healthymatsu.org
Congressional District 00
State/Country of Incorporation AK, USA
Activation Date 2024-01-05
Initial Registration Date 2019-05-16
Entity Start Date 1948-01-15
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 622110, 813211, 813219

Points of Contacts
Electronic Business
Title PRIMARY POC
Name VICTORIA FLINT
Role MS.
Address 777 N CRUSEY ST. SUITE A201, WASILLA, AK, 99654, USA
Title ALTERNATE POC
Name VICTORIA FLINT
Role MS.
Address 777 N CRUSEY ST., SUITE A201, WASILLA, AK, 99654, USA
Government Business
Title PRIMARY POC
Name VICTORIA FLINT
Role MS.
Address 777 N CRUSEY ST., SUITE A201, WASILLA, AK, 99654, USA
Title ALTERNATE POC
Name VICTORIA FLINT
Role MS.
Address 777 N CRUSEY ST., SUITE A201, WASILLA, AK, 99654, USA
Past Performance
Title PRIMARY POC
Name VICTORIA FLINT
Role MS.
Address 777 N CRUSEY ST., SUITE A201, WASILLA, AK, 99654, USA
Title ALTERNATE POC
Name VICTORIA FLINT
Role MS.
Address 777 N CRUSEY ST., SUITE A201, WASILLA, AK, 99654, USA

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300D66Z5P1WFBAC37 2378D US-AK GENERAL ACTIVE -

Addresses
Legal C/O DWT Alaska Corp, 188 West Northern Lights Boulevard, Suite 1100, Anchorage, US-AK, US, 99503
Headquarters 950 East Bogard Road, Suite 218, Wasilla, US-AK, US, 99654

Registration details
Registration Date 2015-11-18
Last Update 2023-08-04
Status LAPSED
Next Renewal 2016-11-15
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 2378D

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
VALLEY HOSPITAL ASSOCIATION, INC. DBA MAT-SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2023 920019395 2024-07-25 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 622000
Sponsor’s telephone number 9073522863
Plan sponsor’s DBA name MAT-SU HEALTH FOUNDATION
Plan sponsor’s address 777 N CRUSEY STREET, SUITE A201, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2024-07-25
Name of individual signing WILLIAM FINLEY
Role Employer/plan sponsor
Date 2024-07-25
Name of individual signing WILLIAM FINLEY
VALLEY HOSPITAL ASSOCIATION, INC. DBA MAT-SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2022 920019395 2023-07-11 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 622000
Sponsor’s telephone number 9073522863
Plan sponsor’s DBA name MAT-SU HEALTH FOUNDATION
Plan sponsor’s address 777 N CRUSEY STREET, SUITE A201, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2023-07-11
Name of individual signing BILL FINLEY
VALLEY HOSPITAL ASSOCIATION, INC. DBA MAT-SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2021 920019395 2022-06-30 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 622000
Sponsor’s telephone number 9073522863
Plan sponsor’s DBA name MAT-SU HEALTH FOUNDATION
Plan sponsor’s address 777 N CRUSEY STREET, SUITE A201, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2022-06-30
Name of individual signing EVIE SHIELDS
VALLEY HOSPITAL ASSOCIATION, INC. DBA MAT-SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2020 920019395 2021-04-22 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 622000
Sponsor’s telephone number 9073522863
Plan sponsor’s DBA name MAT-SU HEALTH FOUNDATION
Plan sponsor’s address 777 N CRUSEY STREET, SUITE A201, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2021-04-22
Name of individual signing SHIRLEY KELLY
VALLEY HOSPITAL ASSOCIATION, INC. DBA MAT-SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2016 920019395 2017-10-10 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 812190
Sponsor’s telephone number 9073522863
Plan sponsor’s DBA name DBA MAT-SU HEALTH FOUNDATION
Plan sponsor’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2017-10-10
Name of individual signing CHRIS EMOND
Role Employer/plan sponsor
Date 2017-10-10
Name of individual signing CHRIS EMOND
MAT SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2015 920019395 2016-05-05 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 812190
Sponsor’s telephone number 9073522868
Plan sponsor’s DBA name MAT SU HEALTH FOUNDATION
Plan sponsor’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2016-05-05
Name of individual signing ELIZABETH RIPLEY
MAT SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2014 920019395 2015-09-30 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 812190
Sponsor’s telephone number 9073522868
Plan sponsor’s DBA name MAT SU HEALTH FOUNDATION
Plan sponsor’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2015-09-30
Name of individual signing ELIZABETH RIPLEY
MAT SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2013 920019395 2014-08-29 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 812190
Sponsor’s telephone number 9073522868
Plan sponsor’s DBA name MAT SU HEALTH FOUNDATION
Plan sponsor’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654

Signature of
Role Plan administrator
Date 2014-08-29
Name of individual signing ELIZABETH RIPLEY
MAT SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2012 920019395 2013-10-10 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 812190
Sponsor’s telephone number 9073522868
Plan sponsor’s DBA name MAT SU HEALTH FOUNDATION
Plan sponsor’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654

Plan administrator’s name and address
Administrator’s EIN 920019395
Plan administrator’s name VALLEY HOSPITAL ASSOCIATION, INC.
Plan administrator’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654
Administrator’s telephone number 9073522868

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing ELIZABETH RIPLEY
MAT SU HEALTH FOUNDATION SAFE HARBOR 401(K) PLAN 2011 920019395 2012-10-16 4
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Sponsor VALLEY HOSPITAL ASSOCIATION, INC.
Business code 812190
Sponsor’s telephone number 9073522868
Plan sponsor’s DBA name MAT SU HEALTH FOUNDATION
Plan sponsor’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654

Plan administrator’s name and address
Administrator’s EIN 920019395
Plan administrator’s name VALLEY HOSPITAL ASSOCIATION, INC.
Plan administrator’s address 950 E. BOGARD ROAD, STE 218, WASILLA, AK, 99654
Administrator’s telephone number 9073522868

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing DON ZOERB, III
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing DON ZOERB, III

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 3641 Active - 2022-10-18 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621610 - HOME HEALTH CARE SERVICES

Date of last update: 10 Jan 2025

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

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