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  5. Provident Senior Health, Inc.

Provident Senior Health, Inc.

Company Details

Name: Provident Senior Health, Inc.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Voluntarily Dissolved
Date of registration: 13 May 2005 (20 years ago)
Date dissolved: 31 Dec 2018
Entity Number: 20051198010
ZIP code: 80031
County: Adams County
Place of Formation: COLORADO
Principal Address: 10301 Perry Street Westminster CO 80031 US
Mailing Address: P.O. Box 350849 Westminster CO 80035-0849 US

Central Index Key

CIK number Mailing Address Business Address Phone
1362927 10301 PERRY STREET, WESTMINSTER, CO, 80031 10301 PERRY STREET, WESTMINSTER, CO, 80031 303-460-8803

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVIDENT SENIOR HEALTH, 2018 202845593 2019-03-25 PROVIDENT SENIOR HEALTH, INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935270
Plan sponsor’s address 701 E HAMPDEN AVENUE, SUITE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2019-03-25
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2017 202845593 2018-06-15 PROVIDENT SENIOR HEALTH, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935270
Plan sponsor’s address 701 E HAMPDEN AVENUE, SUITE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2018-06-15
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2016 202845593 2017-08-10 PROVIDENT SENIOR HEALTH, INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 9999999999
Plan sponsor’s address 701 E HAMPDEN AVENUE, SUITE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2017-08-10
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2015 202845593 2016-06-08 PROVIDENT SENIOR HEALTH, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935274
Plan sponsor’s address 701 E HAMPDEN AVENUE, SUITE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2016-06-08
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2014 202845593 2015-07-08 PROVIDENT SENIOR HEALTH, INC. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935274
Plan sponsor’s address 701 E HAMPDEN AVENUE, SUITE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2015-07-08
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2013 202845593 2014-06-05 PROVIDENT SENIOR HEALTH, INC. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935274
Plan sponsor’s address 701 E HAMPDEN AVENUE, SUITE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2014-06-05
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2012 202845593 2013-10-15 PROVIDENT SENIOR HEALTH, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935272
Plan sponsor’s address 701 E HAMPDEN STE 370, ENGLEWOOD, CO, 80113

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH, INC. 401K PROFIT SHARING PLAN 2011 202845593 2012-10-16 PROVIDENT SENIOR HEALTH, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935272
Plan sponsor’s address 701 E HAMPDEN STE 370, ENGLEWOOD, CO, 80113

Plan administrator’s name and address
Administrator’s EIN 202845593
Plan administrator’s name PROVIDENT SENIOR HEALTH, INC.
Plan administrator’s address 701 E HAMPDEN STE 370, ENGLEWOOD, CO, 80113
Administrator’s telephone number 3034935272

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing WILLIAM NOONING
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH INC 401 K PROFIT SHARING PLAN TRUST 2010 202845593 2011-10-17 PROVIDENT SENIOR HEALTH INC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935272
Plan sponsor’s address PO BOX 60, ENGLEWOOD, CO, 80151

Plan administrator’s name and address
Administrator’s EIN 202845593
Plan administrator’s name PROVIDENT SENIOR HEALTH INC
Plan administrator’s address PO BOX 60, ENGLEWOOD, CO, 80151
Administrator’s telephone number 3034935272

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing PROVIDENT SENIOR HEALTH INC
Valid signature Filed with authorized/valid electronic signature
PROVIDENT SENIOR HEALTH INC 2009 202845593 2010-10-15 PROVIDENT SENIOR HEALTH INC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3034935271
Plan sponsor’s address 2535 S DOWNING ST STE 480, DENVER, CO, 802100000

Plan administrator’s name and address
Administrator’s EIN 202845593
Plan administrator’s name PROVIDENT SENIOR HEALTH INC
Plan administrator’s address 2535 S DOWNING ST STE 480, DENVER, CO, 802100000
Administrator’s telephone number 3034935271

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing PROVIDENT SENIOR HEALTH INC
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
William H Nooning Agent 10301 Perry Street Westminster CO 80031 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20181957923 Dissolve a Profit Corporation 2018-12-07 2018-12-31 Provident Senior Health, Inc., Dissolved December 31, 2018 No data
20181571160 File Report 2018-07-23 2018-07-23 No data Change of Registered Agent Address / Change of Entity Address
20171542329 File Report 2017-07-19 2017-07-19 No data No data
20161397532 File Report 2016-06-08 2016-06-08 No data No data
20151456539 File Report 2015-07-16 2015-07-16 No data No data
20141254213 File Report 2014-04-23 2014-04-23 No data No data
20131322686 File Report 2013-05-29 2013-05-29 No data No data
20121232744 File Report 2012-04-24 2012-04-24 No data No data
20111251528 File Report 2011-04-27 2011-04-27 No data Change of Registered Agent
20101502495 File Report 2010-09-09 2010-09-09 No data Change of Registered Agent Address / Change of Entity Address

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State

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