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  5. Alaska Family Services, Inc.

Alaska Family Services, Inc.

Contents

Company Details

Name: Alaska Family Services, Inc.
Jurisdiction: Alaska
Legal type: Nonprofit Corporation
Status: Good Standing
Date of registration: 26 Aug 1980 (44 years ago)
Entity Number: 22446D
ZIP code: 99645
County: Matanuska Susitna
Place of Formation: ALASKA
Address: 1825 S. CHUGACH STREET, PALMER, AK 99645
Mailing Address: 1825 S CHUGACH ST, PALMER, AK 99645

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621420 OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CENTERS

Officers

Name Role
Deborah Retherford Vice President
Deborah Retherford Director
Nichelle Henry Secretary
Nichelle Henry Treasurer
Nichelle Henry Director
Kenni Linden President
Kenni Linden Director
Ryan Lonergan Director
Lisa Wade Director
Jackie Kenshalo Director

Unique Entity ID

Unique Entity ID Expiration Date Physical Address
LRKBNHYCBH84 2025-03-12 1825 S CHUGACH ST, PALMER, AK, 99645, 6795, USA
Mailing Address 1825 S CHUGACH ST, PALMER, AK, 99645, 6795, USA

Business Information
Doing Business As ALASKA FAMILY SERVICES INC
Congressional District 00
State/Country of Incorporation AK, USA
Activation Date 2024-03-14
Initial Registration Date 2010-04-02
Entity Start Date 1980-08-26
Fiscal Year End Close Date Jun 30

Service Classifications
NAICS Codes 621420, 624190, 624221, 624230

Points of Contacts
Electronic Business
Title PRIMARY POC
Name DESIRE SHEPLER
Address 1825 S. CHUGACH ST., PALMER, AK, 99645, 6795, USA
Government Business
Title PRIMARY POC
Name DESIRE SHEPLER
Address 1825 S. CHUGACH ST., PALMER, AK, 99645, 6795, USA
Past Performance -

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
5YGU5 Active Non-Manufacturer 2010-04-05 2024-06-10 2029-06-10 2025-06-06

Contact Information
POC DESIRE SHEPLER
Phone +1 907-746-4080
Address 1825 S CHUGACH ST, PALMER, AK, 99645 6795, UNITED STATES

Ownership of Offeror Information
Highest Level Owner -
Immediate Level Owner -
List of Offerors (0) -

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
ALASKA FAMILY SERVICES, INC. 2023 920078235 2024-07-19 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-08-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2024-07-19
Name of individual signing PAM BEACHELL
EMPLOYEE BENEFIT PLAN OF ALASKA FAMILY SERVICES, INC. 2023 920078235 2024-07-19 119
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2024-07-19
Name of individual signing PAM BEACHELL
EMPLOYEE BENEFIT PLAN OF ALASKA FAMILY SERVICES, INC. 2022 920078235 2023-07-24 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing PAM BEACHELL
TAX DEFERRED ANNUITY PLAN OF ALASKA FAMILY SERVICES, INC. 2022 920078235 2023-07-24 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-08-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing PAM BEACHELL
TAX DEFERRED ANNUITY PLAN OF ALASKA FAMILY SERVICES, INC. 2021 920078235 2022-06-24 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-08-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2022-06-24
Name of individual signing PAM BEACHELL
EMPLOYEE BENEFIT PLAN OF ALASKA FAMILY SERVICES, INC. 2021 920078235 2022-06-24 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2022-06-24
Name of individual signing PAM BEACHELL
EMPLOYEE BENEFIT PLAN OF ALASKA FAMILY SERVICES, INC. 2020 920078235 2021-07-19 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2021-07-19
Name of individual signing PAM BEACHELL
TAX DEFERRED ANNUITY PLAN OF ALASKA FAMILY SERVICES, INC. 2020 920078235 2021-07-19 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-08-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2021-07-19
Name of individual signing PAM BEACHELL
EMPLOYEE BENEFIT PLAN OF ALASKA FAMILY SERVICES, INC. 2019 920078235 2020-06-25 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2020-06-25
Name of individual signing PAM BEACHELL
TAX DEFERRED ANNUITY PLAN OF ALASKA FAMILY SERVICES, INC. 2019 920078235 2020-06-25 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-08-01
Sponsor ALASKA FAMILY SERVICES, INC.
Business code 624200
Sponsor’s telephone number 9077464080
Plan sponsor’s address 1825 S CHUGACH ST, PALMER, AK, 996456795

Signature of
Role Plan administrator
Date 2020-06-25
Name of individual signing PAM BEACHELL

Business Licenses

License Number Type Status Issue Date Date of renewal Expiration date Description
420981 Business License Active 2001-12-19 2024-11-12 2026-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621420 - OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CENTERS

Professional Licenses

License Number Program Type Status Issue Date Effective Date Expiration Date
126348 Telemedicine Business Registry Telemedicine Business Registry Active 2017-09-07 2017-09-07 -

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
341702397 1050210 2016-08-16 165 EAST PARKS HIGHWAY, WASILLA, AK, 99654
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2016-08-16
Case Closed 2017-04-06

Related Activity
Type Complaint
Activity Nr 1123379
Health Yes

Violation Items
Citation ID 01001A
Citaton Type Other
Standard Cited 19101030 C01 II A
Issuance Date 2016-12-29
Abatement Due Date 2017-02-16
Current Penalty 0.0
Initial Penalty 1625.0
Final Order 2017-01-21
Nr Instances 1
Nr Exposed 17
FTA Current Penalty 0.0
Citation ID 01001B
Citaton Type Other
Standard Cited 19101030 F02 I
Issuance Date 2016-12-29
Abatement Due Date 2017-02-16
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2017-01-21
Nr Instances 5
Nr Exposed 17
FTA Current Penalty 0.0
Citation ID 02001
Citaton Type Other
Standard Cited 19100037 A03
Issuance Date 2016-12-29
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2017-01-21
Nr Instances 2
Nr Exposed 17
FTA Current Penalty 0.0
Citation ID 02002
Citaton Type Other
Standard Cited 19100141 A05
Issuance Date 2016-12-29
Abatement Due Date 2017-02-16
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2017-01-21
Nr Instances 2
Nr Exposed 17
Related Event Code (REC) Complaint
FTA Current Penalty 0.0
Citation ID 02003
Citaton Type Other
Standard Cited 19100303 B02
Issuance Date 2016-12-29
Abatement Due Date 2017-01-05
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2017-01-21
Nr Instances 5
Nr Exposed 17
FTA Current Penalty 0.0
Citation ID 02004
Citaton Type Other
Standard Cited 19100305 G01 IV A
Issuance Date 2016-12-29
Abatement Due Date 2017-01-26
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2017-01-21
Nr Instances 2
Nr Exposed 17
FTA Current Penalty 0.0
Citation ID 02005
Citaton Type Other
Standard Cited 19040030 A
Issuance Date 2016-12-29
Abatement Due Date 2017-01-26
Current Penalty 500.0
Initial Penalty 1000.0
Final Order 2017-01-21
Nr Instances 4
Nr Exposed 4
FTA Current Penalty 0.0
Citation ID 02006
Citaton Type Other
Standard Cited 19040030 A
Issuance Date 2016-12-29
Abatement Due Date 2017-01-26
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2017-01-21
Nr Instances 1
Nr Exposed 1
FTA Current Penalty 0.0

Date of last update: 24 Jan 2025

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

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