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  5. SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC

SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC

Company Details

Name: SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 07 Feb 2005 (20 years ago)
Entity Number: 3160463
ZIP code: 11580
County: Broome
Place of Formation: New York
Address: 10 e. merrick rd. suite 304, VALLEY STREAM, NY, United States, 11580

Contact Details

Phone +1 607-729-9206

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
GR2LN1CYMHQ8 2024-10-22 282 RIVERSIDE DRIVE, JOHNSON CITY, NY, 13790, 2774, USA 282 RIVERSIDE DRIVE, JOHNSON CITY, NY, 13790, 2774, USA

Business Information
URL www.susnursing.com
Congressional District 19
State/Country of Incorporation NY, USA
Activation Date 2023-10-25
Initial Registration Date 2004-03-25
Entity Start Date 2005-03-01
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 623110
Product and Service Codes G004, Q201, Q401, Q402, Q403, Q506, Q999, R499

Points of Contacts
Electronic Business
Title PRIMARY POC
Name DARLENE GALE
Role AR DIRECTOR
Address 455 CAYUGA ROAD, SUITE 200, BUFFALO, NY, 14225, USA
Title ALTERNATE POC
Name MARK JOHNSON
Address 455 CAYUGA ROAD, SUITE 200, BUFFALO, NY, 13790, 2727, USA
Government Business
Title PRIMARY POC
Name DARLENE GALE
Role AR DIRECTOR
Address 455 CAYUGA ROAD, SUITE 200, BUFFALO, NY, 14225, USA
Title ALTERNATE POC
Name MARK JOHNSON
Address 455 CAYUGA ROAD, SUITE 200, BUFFALO, NY, 13790, 2727, USA
Past Performance
Title PRIMARY POC
Name MARK JOHNSON
Address 455 CAYUGA ROAD, SUITE 200, BUFFALO, NY, 14225, 2727, USA
Title ALTERNATE POC
Name MARK JOHNSON
Address 455 CAYUGA ROAD, SUITE 200, BUFFALO, NY, 14225, 2727, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3SVZ5 Active Non-Manufacturer 2004-03-25 2024-03-09 2028-10-25 2024-10-22

Contact Information
POC DARLENE GALE
Phone +1 716-829-1965
Fax +1 716-634-1394
Address 282 RIVERSIDE DRIVE, JOHNSON CITY, NY, 13790 2774, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE DENTAL AND MEDICAL 2013 810663761 2014-07-30 SUSQUEHANNA NURSING & REHABILITATION CENTER LLC 175
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2000-09-01
Business code 623000
Plan sponsor’s mailing address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Number of participants as of the end of the plan year
Active participants 190

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing BERNADETTE BRINSKO
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE LIFE INSURANCE PROGRAM 2013 810663761 2014-07-30 SUSQUEHANNA NURSING & REHABILITATION CENTER LLC 126
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2000-09-01
Business code 623000
Plan sponsor’s mailing address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Number of participants as of the end of the plan year
Active participants 154

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing BERNADETTE BRINSKO
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE DENTAL AND MEDICAL 2012 810663761 2013-10-15 SUSQUEHANNA NURSING & REHABILITATION CENTER 155
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2000-09-01
Business code 623000
Plan sponsor’s mailing address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Number of participants as of the end of the plan year
Active participants 175

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing BERNADETTE BRINSKO
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE LIFE INSURANCE PROGRAM 2012 810663761 2013-10-15 SUSQUEHANNA NURSING & REHABILITATION CENTER LLC 118
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2000-09-01
Business code 623000
Plan sponsor’s mailing address 282 RIVERSIDE DR., JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR., JOHNSON CITY, NY, 13790

Number of participants as of the end of the plan year
Active participants 126

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing BERNADETTE BRINSKO
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE LIFE & DENTAL 2011 810663761 2012-10-15 SUSQUEHANNA NURSING & REHABILITATION CENTER LLC 80
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2000-09-01
Business code 623000
Plan sponsor’s mailing address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Plan administrator’s name and address
Administrator’s EIN 810663761
Plan administrator’s name SUSQUEHANNA NURSING & REHABILITATION CENTER LLC
Plan administrator’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Number of participants as of the end of the plan year
Active participants 80

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing BERNADETTE BRINSKO
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE DENTAL AND MEDICAL 2010 810663761 2011-10-31 SUSQUEHANNA NURSING & REHABILITATION CENTER LLC 121
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2000-09-01
Business code 623000
Sponsor’s telephone number 6077299206
Plan sponsor’s mailing address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Plan administrator’s name and address
Administrator’s EIN 810663761
Plan administrator’s name SUSQUEHANNA NURSING & REHABILITATION CENTER LLC
Plan administrator’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Administrator’s telephone number 6077299206

Number of participants as of the end of the plan year
Active participants 189

Signature of
Role Plan administrator
Date 2011-10-31
Name of individual signing LYNN MURRAY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE DENTAL AND MEDICAL 2010 810663761 2011-10-18 SUSQUEHANNA NURSING & REHABILITATION CENTER LLC 121
Three-digit plan number (PN) 504
Effective date of plan 2000-09-01
Business code 623000
Sponsor’s telephone number 6077299206
Plan sponsor’s mailing address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Plan sponsor’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790

Plan administrator’s name and address
Administrator’s EIN 810663761
Plan administrator’s name SUSQUEHANNA NURSING & REHABILITATION CENTER LLC
Plan administrator’s address 282 RIVERSIDE DR, JOHNSON CITY, NY, 13790
Administrator’s telephone number 6077299206

Number of participants as of the end of the plan year
Active participants 189

Signature of
Role Employer/plan sponsor
Date 2011-10-17
Name of individual signing BERNADETTE BRINSKO
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 10 e. merrick rd. suite 304, VALLEY STREAM, NY, United States, 11580

History

Start date End date Type Value
2005-02-07 2024-04-01 Address 282 RIVERSIDE DRIVE, JOHNSON CITY, NY, 13790, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240401041272 2024-03-20 CERTIFICATE OF CHANGE BY ENTITY 2024-03-20
150205006681 2015-02-05 BIENNIAL STATEMENT 2015-02-01
130214006382 2013-02-14 BIENNIAL STATEMENT 2013-02-01
110406002189 2011-04-06 BIENNIAL STATEMENT 2011-02-01
070226002279 2007-02-26 BIENNIAL STATEMENT 2007-02-01
050429000067 2005-04-29 AFFIDAVIT OF PUBLICATION 2005-04-29
050429000066 2005-04-29 AFFIDAVIT OF PUBLICATION 2005-04-29
050207000121 2005-02-07 ARTICLES OF ORGANIZATION 2005-02-07

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
No data IDV VA528BO0125 2008-04-01 No data No data
Unique Award Key CONT_IDV_VA528BO0125_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ADULT DAY CARE
NAICS Code 621610: HOME HEALTH CARE SERVICES
Product and Service Codes Q401: NURSING SERVICES

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
No data IDV V528A8P5297 2005-04-01 No data No data
Unique Award Key CONT_IDV_V528A8P5297_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SUSQUEHANNA NURSING & REHABILITION CENTER, LLC
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME CARE CONTRACTS

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
DO AWARD VA528FY10FPDSRPT 2009-10-01 2010-09-30 2011-03-31
Unique Award Key CONT_AWD_VA528FY10FPDSRPT_3600_VA528BO0125_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title EXPRESS REPORT FY10 ADHC SYRACUSE
NAICS Code 621610: HOME HEALTH CARE SERVICES
Product and Service Codes Q401: NURSING SERVICES

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
DO AWARD VA528FY11Q1Q3 2010-10-01 2011-03-31 2011-03-31
Unique Award Key CONT_AWD_VA528FY11Q1Q3_3600_V528A8P5297_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title DO-EXPRESS REPORT CHN SYRACUSE GEC EXPENDITURES
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME CARE CONTRACTS

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
No data IDV VA528BO0297 2011-04-01 No data No data
Unique Award Key CONT_IDV_VA528BO0297_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 0.00

Description
Title CT CRITICAL FUNCTION COMMUNITY NURSING HOME SYRACUSE
NAICS Code 623110: NURSING CARE FACILITIES
Product and Service Codes Q402: NURSING HOME CARE CONTRACTS

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, BROOME, NEW YORK, 137902727
DELIVERY ORDER AWARD VA528FY11Q1Q3 2011-04-19 2011-06-30 2016-03-31
Unique Award Key CONT_AWD_VA528FY11Q1Q3_3600_VA528BO0297_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 56415.00
Current Award Amount 56415.00
Potential Award Amount 56415.00

Description
Title CNH SYRACUSE
NAICS Code 623110: NURSING CARE FACILITIES
Product and Service Codes Q506: GERIATRIC SERVICES

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, BROOME, NEW YORK, 137902727
DO AWARD VA528FY11Q1Q3 2011-04-01 2011-06-30 2011-06-30
Unique Award Key CONT_AWD_VA528FY11Q1Q3_3600_VA528BO0293_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title EXPRESS REPORT FPDS EXPENDITURES FOR ADHC FOR SYRACUSE
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q506: GERIATRIC SERVICES

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
No data IDV VA528BO0293 2011-04-01 No data No data
Unique Award Key CONT_IDV_VA528BO0293_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title CNH SYRACUSE
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q506: GERIATRIC SERVICES

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
DO AWARD VA528FY12Q4 2012-07-01 2012-09-30 2012-09-30
Unique Award Key CONT_AWD_VA528FY12Q4_3600_VA528BO0293_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title EXPRESS REPORT FPDS EXPENDITURES FOR ADHC SYRACUSE
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q506: MEDICAL- GERIATRIC

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Legacy DUNS 057770687
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, 137902727
DELIVERY ORDER AWARD VA528FY12Q4 2012-07-01 2012-09-30 2012-09-30
Unique Award Key CONT_AWD_VA528FY12Q4_3600_VA528BO0297_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 50000.00
Current Award Amount 50000.00
Potential Award Amount 50000.00

Description
Title EXPRESS REPORT FPDS EXPENDITURES FOR CNH SYRACUSE
NAICS Code 623110: NURSING CARE FACILITIES
Product and Service Codes Q506: MEDICAL- GERIATRIC

Recipient Details
Recipient SUSQUEHANNA NURSING & REHABILITATION CENTER, LLC
UEI GR2LN1CYMHQ8
Recipient Address UNITED STATES, 282 RIVERSIDE DR, JOHNSON CITY, BROOME, NEW YORK, 137902727

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10 e. merrick rd. suite 304, VALLEY STREAM, NY, United States, 11580

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Date of last update: 01 Jan 2025

Sources: New York Secretary of State

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