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  5. Southeast Behavioral Health Group

Southeast Behavioral Health Group

Company Details

Name: Southeast Behavioral Health Group
Jurisdiction: Colorado
Legal type: Domestic nonprofit corporation
Status: Merged
Date of registration: 21 Nov 2009 (15 years ago)
Entity Number: 20091612274
ZIP code: 81050
County: Otero County
Place of Formation: COLORADO
Principal Address: 711 Barnes Ave La Junta CO 81050 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHEAST BEHAVIORAL HEALTH GROUP (LIFE INSURANCE) 2020 271388543 2021-11-30 SOUTHEAST BEHAVIORAL HEALTH GROUP 140
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2005-01-02
Business code 621330
Sponsor’s telephone number 7193835450
Plan sponsor’s DBA name SOUTHEAST HEALTH GROUP
Plan sponsor’s mailing address 711 BARNES AVE, LA JUNTA, CO, 810502138
Plan sponsor’s address 711 BARNES AVE, LA JUNTA, CO, 810502138

Number of participants as of the end of the plan year
Active participants 133

Signature of
Role Plan administrator
Date 2021-11-30
Name of individual signing DIVENA MORTIMEYER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-11-30
Name of individual signing DIVENA MORTIMEYER
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST BEHAVIORAL HEALTH GROUP (LIFE INSURANCE) 2019 271388543 2020-07-08 SOUTHEAST BEHAVIORAL HEALTH GROUP 122
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2005-01-02
Business code 621330
Sponsor’s telephone number 7193845446
Plan sponsor’s DBA name SOUTHEAST HEALTH GROUP
Plan sponsor’s mailing address 711 BARNES AVE, LA JUNTA, CO, 810502138
Plan sponsor’s address 711 BARNES AVE, LA JUNTA, CO, 810502138

Number of participants as of the end of the plan year
Active participants 140
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing BARRY SHIOSHITA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-08
Name of individual signing BARRY SHIOSHITA
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST BEHAVIORAL HEALTH GOUP (LIFE & LTD INSURANCE) 2017 271388543 2018-06-12 SOUTHEAST BEHAVIORAL HEALTH GROUP 109
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2005-01-01
Business code 621420
Sponsor’s telephone number 7193845446
Plan sponsor’s mailing address 711 BARNES AVE, LA JUNTA, CO, 810502138
Plan sponsor’s address 711 BARNES AVE, LA JUNTA, CO, 810502138

Number of participants as of the end of the plan year
Active participants 108
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2018-06-12
Name of individual signing JEANNIE LARSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-12
Name of individual signing BARRY SHIOSHITA
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST HEALTH GROUP 2013 271388543 2014-07-28 SOUTHEAST BEHAVIORAL HEALTH GROUP 148
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 7193845446
Plan sponsor’s DBA name SOUTHEAST HEALTH GROUP
Plan sponsor’s mailing address 711 BARNES AVE, LA JUNTA, CO, 81050
Plan sponsor’s address 711 BARNES AVE, LA JUNTA, CO, 81050

Number of participants as of the end of the plan year
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing BECKY OTTEMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-28
Name of individual signing BECKY OTTEMAN
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST BEHAVIORAL HEALTH GROUP MONEY PURCHASE PENSION PLAN 2010 271388543 2011-04-12 SOUTHEAST BEHAVIORAL HEALTH GROUP 59
Three-digit plan number (PN) 001
Effective date of plan 1981-03-01
Business code 621330
Sponsor’s telephone number 7193845446
Plan sponsor’s address 711 BARNES AVENUE, LA JUNTA, CO, 81050

Plan administrator’s name and address
Administrator’s EIN 271388543
Plan administrator’s name SOUTHEAST BEHAVIORAL HEALTH GROUP
Plan administrator’s address 711 BARNES AVENUE, LA JUNTA, CO, 81050
Administrator’s telephone number 7193845446

Signature of
Role Plan administrator
Date 2011-04-12
Name of individual signing ROBERT WHALEY
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-04-12
Name of individual signing ROBERT WHALEY
Valid signature Filed with incorrect/unrecognized electronic signature
SOUTHEAST BEHAVIORAL HEALTH GROUP MONEY PURCHASE PENSION PLAN 2010 271388543 2011-05-03 SOUTHEAST BEHAVIORAL HEALTH GROUP 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-03-01
Business code 621330
Sponsor’s telephone number 7193845446
Plan sponsor’s address 711 BARNES AVENUE, LA JUNTA, CO, 81050

Plan administrator’s name and address
Administrator’s EIN 271388543
Plan administrator’s name SOUTHEAST BEHAVIORAL HEALTH GROUP
Plan administrator’s address 711 BARNES AVENUE, LA JUNTA, CO, 81050
Administrator’s telephone number 7193845446

Signature of
Role Plan administrator
Date 2011-05-03
Name of individual signing ROBERT WHALEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-03
Name of individual signing ROBERT WHALEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Joseph C Carrica III Agent 711 Barnes Ave La Junta CO 81050 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20231818428 Statement of Merger 2023-08-03 2023-08-03 No data Merged to VALLEY WIDE HEALTH SYSTEMS, INC.
20228032735 File Report 2022-10-24 2022-10-24 No data Principal address changed, Change in registered agent information
20218011412 File Report 2021-10-25 2021-10-25 No data No data
20211075472 File Report 2021-01-25 2021-01-25 No data No data
20191857898 File Report 2019-10-25 2019-10-25 No data No data
20181825374 File Report 2018-10-23 2018-10-23 No data Change of Registered Agent
20171827114 File Report 2017-11-01 2017-11-01 No data Change of Registered Agent
20161731576 File Report 2016-10-26 2016-10-26 No data No data
20151680025 File Report 2015-10-23 2015-10-23 No data No data
20141658218 File Report 2014-10-28 2014-10-28 No data No data

Related by officers

No related officers

Related by address

711 Barnes Ave La Junta CO 81050 US

Southeast Wellness Works LLC Partnership For Progress SOUTHEAST MENTAL HEALTH SERVICES

Date of last update: 27 Jan 2025

Sources: Colorado's Secretary of State

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