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  5. PELLEGRINO HEALING CENTER, LLC

PELLEGRINO HEALING CENTER, LLC

Company Details

Name: PELLEGRINO HEALING CENTER, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 04 Oct 2018 (7 years ago)
Entity Number: 5420356
ZIP code: 12586
County: Dutchess
Place of Formation: New York
Address: 220 BEL AIR ROAD, WALDEN, NY, United States, 12586

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PELLEGRINO HEALING CENTER 401(K) PLAN 2023 832185387 2024-05-31 PELLEGRINO HEALING CENTER 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-05-31
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2022 832185387 2023-08-18 PELLEGRINO HEALING CENTER 4
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-08-18
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2022 832185387 2024-05-24 PELLEGRINO HEALING CENTER 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-05-24
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2021 832185387 2022-09-23 PELLEGRINO HEALING CENTER 3
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing TARA EVANS
PELLEGRINO HEALING CENTER 401(K) PLAN 2021 832185387 2023-08-17 PELLEGRINO HEALING CENTER 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-08-17
Name of individual signing TARA EVANS, FOR TAG RESOURCES
PELLEGRINO HEALING CENTER 401(K) PLAN 2020 832185387 2021-10-01 PELLEGRINO HEALING CENTER 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 8452335672
Plan sponsor’s address 4307 ALBANY POST ROAD, HYDE PARK, NY, 12538

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-10-01
Name of individual signing PHIL TISUE

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 220 BEL AIR ROAD, WALDEN, NY, United States, 12586

Filings

Filing Number Date Filed Type Effective Date
181127000615 2018-11-27 CERTIFICATE OF PUBLICATION 2018-11-27
181004000116 2018-10-04 ARTICLES OF ORGANIZATION 2018-10-04

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4839957001 2020-04-04 0202 PPP 4307 ALBANY POST RD, HYDE PARK, NY, 12538-3601
Loan Status Date 2021-07-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 20000
Loan Approval Amount (current) 36900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 101526
Servicing Lender Name Hudson Valley CU
Servicing Lender Address 137 Boardman Rd, POUGHKEEPSIE, NY, 12603-4821
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address HYDE PARK, DUTCHESS, NY, 12538-3601
Project Congressional District NY-18
Number of Employees 5
NAICS code 621399
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 101526
Originating Lender Name Hudson Valley CU
Originating Lender Address POUGHKEEPSIE, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 37309.44
Forgiveness Paid Date 2021-06-04
6541178300 2021-01-27 0202 PPS 4307 Albany Post Rd, Hyde Park, NY, 12538-3601
Loan Status Date 2022-01-14
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 37900
Loan Approval Amount (current) 37900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 101526
Servicing Lender Name Hudson Valley CU
Servicing Lender Address 137 Boardman Rd, POUGHKEEPSIE, NY, 12603-4821
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Hyde Park, DUTCHESS, NY, 12538-3601
Project Congressional District NY-18
Number of Employees 5
NAICS code 621399
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 101526
Originating Lender Name Hudson Valley CU
Originating Lender Address POUGHKEEPSIE, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 38244.73
Forgiveness Paid Date 2021-12-28

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State

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