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  5. PETERSBURG MENTAL HEALTH SERVICES, INC.

PETERSBURG MENTAL HEALTH SERVICES, INC.

Company Details

Name: PETERSBURG MENTAL HEALTH SERVICES, INC.
Jurisdiction: Alaska
Legal type: Nonprofit Corporation
Status: Good Standing
Date of registration: 01 Aug 1994 (30 years ago)
Entity Number: 54411D
ZIP code: 99833
County: Petersburg
Place of Formation: ALASKA
Address: 100 FRAM, PETERSBURG, AK 99833
Mailing Address: PO BOX 1309, PETERSBURG, AK 99833

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

624190 OTHER INDIVIDUAL AND FAMILY SERVICES

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
7AT71 Active Non-Manufacturer 2015-01-22 2023-02-06 2027-01-14 2023-02-06

Contact Information
POC SUSAN OHMER
Phone +1 907-772-3332
Address 100 FRAM ST STE 2, PETERSBURG, AK, 99833, 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
PETERSBURG MENTAL HEALTH 403(B) PLAN 2022 920151413 2024-01-29 PETERSBURG MENTAL HEALTH SERVICES, INC. 3
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address P.O. BOX 1309, PETERSBURG, AK, 998331309

Signature of
Role Plan administrator
Date 2023-12-06
Name of individual signing KATHY O'REAR
Role Employer/plan sponsor
Date 2023-12-06
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2021 920151413 2023-01-16 PETERSBURG MENTAL HEALTH SERVICES, INC. 18
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address P.O. BOX 1309, PETERSBURG, AK, 998331309

Signature of
Role Plan administrator
Date 2022-11-14
Name of individual signing KATHY O'REAR
Role Employer/plan sponsor
Date 2022-11-14
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2020 920151413 2022-01-31 PETERSBURG MENTAL HEALTH SERVICES, INC. 20
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address P.O. BOX 1309, PETERSBURG, AK, 998331309

Signature of
Role Plan administrator
Date 2022-01-05
Name of individual signing KATHY O'REAR
Role Employer/plan sponsor
Date 2022-01-05
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2019 920151413 2021-01-27 PETERSBURG MENTAL HEALTH SERVICES, INC. 20
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address P.O. BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2021-01-14
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2018 920151413 2020-01-21 PETERSBURG MENTAL HEALTH SERVICES, INC. 20
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address P.O. BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2020-01-20
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2017 920151413 2019-01-28 PETERSBURG MENTAL HEALTH SERVICES, INC 19
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address PO BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2019-01-28
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2016 920151413 2017-10-24 PETERSBURG MENTAL HEALTH SERVICES, INC 32
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address PO BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2017-10-24
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2015 920151413 2017-01-19 PETERSBURG MENTAL HEALTH SERVICES, INC 30
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address PO BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2017-01-19
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2014 920151413 2015-10-21 PETERSBURG MENTAL HEALTH SERVICES, INC 16
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address PO BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2015-10-21
Name of individual signing KATHY O'REAR
PETERSBURG MENTAL HEALTH 403(B) PLAN 2013 920151413 2015-04-13 PETERSBURG MENTAL HEALTH SERVICES, INC 16
File View Page
Three-digit plan number (PN) 101
Effective date of plan 1996-10-28
Business code 621330
Sponsor’s telephone number 9077723332
Plan sponsor’s address PO BOX 1309, PETERSBURG, AK, 99833

Signature of
Role Plan administrator
Date 2015-04-13
Name of individual signing FRAN JONES

Director

Name Role
Michelle Brock Director
ERIN MICHAEL Director
Bridget Wittstock Director
Rexanne Stafford Director

Vice President

Name Role
Michelle Brock Vice President

President

Name Role
ERIN MICHAEL President

Treasurer

Name Role
Bridget Wittstock Treasurer

Registered Agent

Name Role
Susan Ohmer Registered Agent

Secretary

Name Role
Bridget Wittstock Secretary

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 972075 Active 2012-03-27 2023-10-06 2025-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS

Related by officers

Bridget Wittstock

Sound View Bed and Breakfast, LLC

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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