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CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.

Company Details

Name: CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 20 Jun 1997 (28 years ago)
Entity Number: 2155534
ZIP code: 11218
County: Richmond
Place of Formation: New York
Principal Address: 25 FANNING ST, STATEN ISLAND, NY, United States, 10314
Address: 1425 37TH STreet, SUITE 201, BROOKLYN, NY, United States, 11218

Contact Details

Phone +1 718-289-7900

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER 401(K) PLAN 2010 133954527 2011-10-04 CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER 380
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1993-05-01
Business code 623000
Sponsor’s telephone number 7182612100
Plan sponsor’s mailing address 25 FANNING STREET, STATEN ISLAND, NY, 10314
Plan sponsor’s address 25 FANNING STREET, STATEN ISLAND, NY, 10314

Plan administrator’s name and address

Administrator’s EIN 133954527
Plan administrator’s name CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER
Plan administrator’s address 25 FANNING STREET, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7182612100

Number of participants as of the end of the plan year

Active participants 250
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 88
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 294
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 2011-10-03
Name of individual signing NICHOLAS DEMISAY
Valid signature Filed with authorized/valid electronic signature
CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER 401(K) PLAN 2009 133954527 2011-12-28 CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER 380
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1993-05-01
Business code 623000
Sponsor’s telephone number 7182612100
Plan sponsor’s mailing address 25 FANNING STREET, STATEN ISLAND, NY, 10314
Plan sponsor’s address 25 FANNING STREET, STATEN ISLAND, NY, 10314

Plan administrator’s name and address

Administrator’s EIN 133954527
Plan administrator’s name CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER
Plan administrator’s address 25 FANNING STREET, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7182612100

Number of participants as of the end of the plan year

Active participants 281
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 99
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 302
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 2011-12-28
Name of individual signing NICHOLAS DEMISAY
Valid signature Filed with authorized/valid electronic signature
CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER 401(K) PLAN 2009 133954527 2010-10-13 CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER 380
Three-digit plan number (PN) 002
Effective date of plan 1993-05-01
Business code 623000
Sponsor’s telephone number 7182612100
Plan sponsor’s mailing address 25 FANNING STREET, STATEN ISLAND, NY, 10314
Plan sponsor’s address 25 FANNING STREET, STATEN ISLAND, NY, 10314

Plan administrator’s name and address

Administrator’s EIN 133954527
Plan administrator’s name CLOVE LAKES HEALTH CARE AND REHABILITATION CENTER
Plan administrator’s address 25 FANNING STREET, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7182612100

Number of participants as of the end of the plan year

Active participants 281
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 99
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 302
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 2010-10-13
Name of individual signing NICHOLAS DEMISAY
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
FILE RIGHT DOS Process Agent 1425 37TH STreet, SUITE 201, BROOKLYN, NY, United States, 11218

Agent

Name Role Address
mark fuchs Agent c/o file right llc, 1425 37th street suite 201, BROOKLYN, NY, 11218

Chief Executive Officer

Name Role Address
SOLOMON KLEIN Chief Executive Officer 25 FANNING ST, STATEN ISLAND, NY, United States, 10314

History

Start date End date Type Value
2025-03-21 2025-03-21 Address 25 FANNING ST, STATEN ISLAND, NY, 10314, USA (Type of address: Chief Executive Officer)
2025-03-19 2025-03-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-11-26 2025-03-19 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-14 2024-11-26 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-08 2024-10-08 Address 25 FANNING ST, STATEN ISLAND, NY, 10314, USA (Type of address: Chief Executive Officer)
2024-10-08 2025-03-21 Address P.O. BOX 140703, 25 FANNING ST, STATEN ISLAND, NY, 10314, USA (Type of address: Service of Process)
2024-10-08 2025-03-21 Address 25 FANNING ST, STATEN ISLAND, NY, 10314, USA (Type of address: Chief Executive Officer)
2024-10-08 2024-10-14 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-09-26 2024-10-08 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-08-23 2024-09-26 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
250321001907 2025-03-19 CERTIFICATE OF CHANGE BY ENTITY 2025-03-19
241008001882 2024-10-08 BIENNIAL STATEMENT 2024-10-08
210601061632 2021-06-01 BIENNIAL STATEMENT 2021-06-01
210420060204 2021-04-20 BIENNIAL STATEMENT 2019-06-01
110711002639 2011-07-11 BIENNIAL STATEMENT 2011-06-01
090603002707 2009-06-03 BIENNIAL STATEMENT 2009-06-01
070627002026 2007-06-27 BIENNIAL STATEMENT 2007-06-01
050819002525 2005-08-19 BIENNIAL STATEMENT 2005-06-01
030522002649 2003-05-22 BIENNIAL STATEMENT 2003-06-01
010605002878 2001-06-05 BIENNIAL STATEMENT 2001-06-01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9926598400 2021-02-18 0202 PPP 25 Fanning St, Staten Island, NY, 10314-5307
Loan Status Date 2022-10-25
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 7908825
Loan Approval Amount (current) 7908825
Undisbursed Amount 0
Franchise Name -
Lender Location ID 121508
Servicing Lender Name CFG Community Bank
Servicing Lender Address 2455 House St, Baltimore, MD, 21230
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Staten Island, RICHMOND, NY, 10314-5307
Project Congressional District NY-11
Number of Employees 490
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 121508
Originating Lender Name CFG Community Bank
Originating Lender Address Baltimore, MD
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 8036684.34
Forgiveness Paid Date 2022-09-29

Date of last update: 31 Mar 2025

Sources: New York Secretary of State