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  5. LONG ISLAND SELECT HEALTHCARE, INC.

LONG ISLAND SELECT HEALTHCARE, INC.

Company Details

Name: LONG ISLAND SELECT HEALTHCARE, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 12 May 2014 (11 years ago)
Entity Number: 4575618
ZIP code: 11722
County: Nassau
Place of Formation: New York
Address: 159 CARLETON AVENUE, CENTRAL ISLIP, NY, United States, 11722

Contact Details

Phone +1 631-543-5100

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
SH8NLUGZVKS5 2024-08-01 159 CARLETON AVE, CENTRAL ISLIP, NY, 11722, 4172, USA 159 CARLETON AVE, CENTRAL ISLIP, NY, 11722, 4172, USA

Business Information
Doing Business As LONG ISLAND SELECT HEALTHCARE
Division Name LONG ISLAND SELECT HEALTHCARE, INC.
Congressional District 02
State/Country of Incorporation NY, USA
Activation Date 2023-08-03
Initial Registration Date 2014-07-28
Entity Start Date 2014-05-13
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621112, 621210, 621399, 621498
Product and Service Codes Q503, Q509, Q510, Q511, Q516, Q518, Q519, Q520, Q526, Q999

Points of Contacts
Electronic Business
Title PRIMARY POC
Name KAM SATTAR
Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, USA
Government Business
Title PRIMARY POC
Name KAM SATTAR
Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, USA
Past Performance
Title ALTERNATE POC
Name KAM SATTAR
Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
76M25 Active Non-Manufacturer 2014-08-08 2024-08-13 2029-08-13 2025-08-09

Contact Information
POC KAM SATTAR
Phone +1 631-650-2087
Fax +1 631-650-0497
Address 159 CARLETON AVE, CENTRAL ISLIP, NY, 11722 4172, 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
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2020 471001464 2022-09-22 LONG ISLAND SELECT HEALTHCARE 116
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2022-09-22
Name of individual signing JAMES HOLLAND
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2020 471001464 2021-07-29 LONG ISLAND SELECT HEALTHCARE 116
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2021-07-29
Name of individual signing JAMES HOLLAND
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2020 471001464 2022-10-14 LONG ISLAND SELECT HEALTHCARE 116
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing JAMES HOLLAND
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2020 471001464 2021-07-28 LONG ISLAND SELECT HEALTHCARE 116
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing MARK BOEHRER
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2019 471001464 2020-08-24 LONG ISLAND SELECT HEALTHCARE 109
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2020-08-24
Name of individual signing JAMES HOLLAND
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2018 471001464 2019-03-29 LONG ISLAND SELECT HEALTHCARE 111
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2019-03-29
Name of individual signing JAMES HOLLAND
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2017 471001464 2018-07-18 LONG ISLAND SELECT HEALTHCARE 117
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2018-07-18
Name of individual signing JAMES HOLLAND
LONG ISLAND SELECT HEALTHCARE RETIREMENT PLAN 2016 471001464 2017-07-20 LONG ISLAND SELECT HEALTHCARE 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621498
Sponsor’s telephone number 6314394300
Plan sponsor’s address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722

Signature of
Role Plan administrator
Date 2017-07-20
Name of individual signing JAMES HOLLAND

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 159 CARLETON AVENUE, CENTRAL ISLIP, NY, United States, 11722

History

Start date End date Type Value
2014-05-12 2016-12-09 Address C/O GARFUNKEL WILD, P.C., 111 GREAT NECK ROAD SUITE 600, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
161209000507 2016-12-09 CERTIFICATE OF AMENDMENT 2016-12-09
140512000228 2014-05-12 CERTIFICATE OF INCORPORATION 2014-05-12

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
47-1001464 Corporation Unconditional Exemption 159 CARLETON AVE, CENTRAL ISLIP, NY, 11722-4172 2016-07
In Care of Name % EDGARDO UY
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 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 17327133
Income Amount 24397842
Form 990 Revenue Amount 24397842
National Taxonomy of Exempt Entities Health Care: Hospital, General
Sort Name LISH INC

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)

Determination Letter
Final Letter(s) FinalLetter_47-1001464_LISHINC_03312016.tif

Form 990-N (e-Postcard)
Organization Name LISH INC
EIN 47-1001464
Tax Year 2015
Beginning of tax period 2015-01-01
End of tax period 2015-12-31
Gross receipts not greater than $50000 Yes
Organization has terminated No
Mailing Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, US
Principal Officer's Name TRACY G MCDANIEL
Principal Officer's Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, US
Organization Name LISH INC
EIN 47-1001464
Tax Year 2014
Beginning of tax period 2014-05-12
End of tax period 2014-12-31
Gross receipts not greater than $50000 Yes
Organization has terminated No
Mailing Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, US
Principal Officer's Name TRACY G MCDANIEL
Principal Officer's Address 159 CARLETON AVENUE, CENTRAL ISLIP, NY, 11722, US

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 201912
Filing Type P
Return Type 990T
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 201812
Filing Type P
Return Type 990T
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name LONG ISLAND SELECT HEALTHCARE INC
EIN 47-1001464
Tax Period 201612
Filing Type P
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6244117007 2020-04-06 0235 PPP 159 CARLETON AVE, CENTRAL ISLIP, NY, 11722-4172
Loan Status Date 2020-12-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1514800
Loan Approval Amount (current) 1514800
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46391
Servicing Lender Name Manufacturers and Traders Trust Company
Servicing Lender Address One M & T Plaza, 15th Fl, BUFFALO, NY, 14203
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address CENTRAL ISLIP, SUFFOLK, NY, 11722-4172
Project Congressional District NY-02
Number of Employees 113
NAICS code 624190
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 15793
Originating Lender Name Manufacturers and Traders Trust Company
Originating Lender Address Bridgeport, CT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 1523017.27
Forgiveness Paid Date 2020-11-05

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Related by address

No related companies by address

Date of last update: 25 Mar 2025

Sources: New York Secretary of State

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