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  5. ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC.

ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC.

Company Details

Name: ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 27 Jan 2003 (22 years ago)
Entity Number: 2861793
ZIP code: 12853
County: Warren
Place of Formation: New York
Address: C/O KAREN SMITH, PO BOX 246, NORTH CREEK, NY, United States, 12853

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION 2017 234230007 2018-11-02 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 97
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2018-11-02
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2018-11-02
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2017 234230007 2018-02-20 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 112
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2018-02-20
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2018-02-20
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2016 234230007 2017-09-05 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 111
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2017-09-05
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2017-09-05
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2015 234230007 2016-06-03 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 119
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2016-06-03
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2016-06-03
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2014 234230007 2015-10-13 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 113
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2015-10-13
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2013 234230007 2014-05-23 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 119
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2014-05-23
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2014-05-23
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2012 234230007 2013-05-06 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 105
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Signature of
Role Plan administrator
Date 2013-05-06
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2013-05-06
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2011 234230007 2012-04-26 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 119
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Plan administrator’s name and address
Administrator’s EIN 234230007
Plan administrator’s name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC.
Plan administrator’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853
Administrator’s telephone number 5182512447

Signature of
Role Plan administrator
Date 2012-04-26
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2012-04-26
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2010 234230007 2011-03-29 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 96
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Plan administrator’s name and address
Administrator’s EIN 234230007
Plan administrator’s name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC.
Plan administrator’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853
Administrator’s telephone number 5182512447

Signature of
Role Plan administrator
Date 2011-03-29
Name of individual signing ANN WOODARD
Role Employer/plan sponsor
Date 2011-03-29
Name of individual signing ANN WOODARD
ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. SAVINGS PLAN 2010 234230007 2011-03-29 ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC. 96
Three-digit plan number (PN) 002
Effective date of plan 1985-03-01
Business code 623000
Sponsor’s telephone number 5182512447
Plan sponsor’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853

Plan administrator’s name and address
Administrator’s EIN 234230007
Plan administrator’s name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER, INC.
Plan administrator’s address 112 SKI BOWL ROAD, NORTH CREEK, NY, 12853
Administrator’s telephone number 5182512447

Signature of
Role Plan administrator
Date 2011-03-29
Name of individual signing ANN WOODARD

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent C/O KAREN SMITH, PO BOX 246, NORTH CREEK, NY, United States, 12853

History

Start date End date Type Value
2003-01-27 2018-02-20 Address P.O. BOX 500, SKI BOWL ROAD, NORTH CREEK, NY, 12853, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180220000438 2018-02-20 CERTIFICATE OF CHANGE 2018-02-20
030127000349 2003-01-27 CERTIFICATE OF INCORPORATION 2003-01-27

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
23-4230007 Corporation Unconditional Exemption 3963 STATE RTE 28, NORTH RIVER, NY, 12856-0000 2003-07
In Care of Name % KAREN SMITH
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 1 to 9,999
Income 0
Filing Requirement 990 - Required to file Form 990-N - Income less than $50,000 per year
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 1505
Income Amount 0
Form 990 Revenue Amount 0
National Taxonomy of Exempt Entities Health Care: Nursing, Convalescent Facilities
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 202212
Filing Type E
Return Type 990EZ
File View File
Organization Name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 202112
Filing Type E
Return Type 990EZ
File View File
Organization Name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 201912
Filing Type E
Return Type 990EZ
File View File
Organization Name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name ADIRONDACK TRI-COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name ADIRONDAK TRI COUNTY NURSING AND REHABILITATION CENTER INC
EIN 23-4230007
Tax Period 201512
Filing Type E
Return Type 990
File View File

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Date of last update: 12 Mar 2025

Sources: New York Secretary of State

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