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CHILDREN'S COUNTRY HOME

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Company Details

Legal Name: CHILDREN'S COUNTRY HOME
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Merged
Formation/ Registration Date: November 18th 1996
Date of Dissolution: July 1st 2024
Expiration date: 30 Nov 2024
UBI Number: 601 751 853
FEIN Number: 84-1378062
Purpose: TO ENHANCE THE QUALITY OF LIFE OF MEDICALLY FRAGILE CHILDREN BY PROVIDING 24-HOUR HEALTHCARE SERVICES IN A LOVING, FAMILY CENTERED HOME GUIDED BY THE VALUES OF DIGNITY, COMPASSION, SHARING AND STEWARDSHIP.
ZIP code: 98072
City: Woodinville
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 14643 NE 166TH ST, WOODINVILLE, WA, 98072-9013, UNITED STATES

Contact Details

E-Mail: DIANE@CHILDRENSCOUNTRYHOME.ORG
diane@childrenscountryhome.org
Website: www.childrenscountryhome.org
Phone Number: +1 425-806-9453

Nature of Business

PEDIATRIC GROUP HOME FOR MEDICALLY FRAGILE CHILDREN. STAFFED 24 HOURS PER DAY, 7 DAYS PER WEEK WITH AN RN AND/OR LPN AND CNAS.

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Registered Agent Information

Name Role Address
CHILDREN'S COUNTRY HOME Registered Agent 14643 NE 166TH ST, WOODINVILLE, WA, 98072-9013, UNITED STATES

Key Officers & Management

Name Role Address
SAM DAVIDSON Governing Person -
SUELLEN HOWARD Governing Person -
JASON POULIOTT Governing Person -
KRISTIN ROSSMAN Governing Person -
RYAN WONG Governing Person -
CHARLES HEANEY Governing Person -
ED ANDERSON Governing Person -
VERONICA COOK Governing Person -
RYAN WONG TREASURER 14643 NE 166TH ST, WOODINVILLE, WA, 98072-9013, UNITED STATES
CHARLES HEANEY PRESIDENT 14643 NE 166TH ST, WOODINVILLE, WA, 98072-9013, UNITED STATES

National Provider Identifier

NPI Number:
1386161289
Link:
View on NPI website

Authorized Person:

Name:
MS. DIANE KOLB
Role:
EXECUTIVE DIRECTOR
Phone:
4258069453

Taxonomy:

Selected Taxonomy:
251E00000X - Home Health Agency
Is Primary:
Yes

Contacts:

Phone:
+1 425-806-9453
Fax:
4254851527

Form 5500 Series

Employer Identification Number (EIN):
841378062
Plan Year:
2023
Number Of Participants:
25
Plan Name:
401(K)
Sponsor's telephone number:
4258069453
File:
View File
Plan Administrator / Signatory:
DIANE KOLB(Plan administrator)
Plan Year:
2022
Number Of Participants:
21
Plan Name:
401(K)
Sponsor's telephone number:
4258069453
File:
View File
Plan Administrator / Signatory:
DIANE KOLB(Plan administrator)
Plan Year:
2021
Number Of Participants:
22
Plan Name:
401(K)
Sponsor's telephone number:
4258069453
File:
View File
Plan Administrator / Signatory:
EDWARD ROJAS(Plan administrator)
Plan Year:
2020
Number Of Participants:
18
Plan Name:
401(K)
Sponsor's telephone number:
4258069453
File:
View File
Plan Administrator / Signatory:
DIANE KOLB(Plan administrator)
Plan Year:
2019
Number Of Participants:
18
Plan Name:
401(K)
Sponsor's telephone number:
4258069453
File:
View File
Plan Administrator / Signatory:
DIANE KOLB(Plan administrator)

Charity/Fundraiser/Trust

Registration Number:
1108871
Type:
CHARITABLE ORGANIZATION
Status:
Involuntarily Closed
Renewal Date:
2025-05-31

Financial History

Fiscal Begin Date:
2022-07-01
Fiscal End Date:
2023-06-30
Begin Assets:
$2,135,266.00
Revenue:
$2,060,841.00
Program Services:
$2,106,251.00
Expenses:
$2,312,472.00
End Assets:
$1,922,080.00
% To Program Services:
91%
Fiscal Begin Date:
2021-07-01
Fiscal End Date:
2022-06-30
Begin Assets:
$2,186,188.00
Revenue:
$2,192,877.00
Program Services:
$1,930,260.00
Expenses:
$2,110,605.00
End Assets:
$2,135,266.00
% To Program Services:
91%
Fiscal Begin Date:
2020-07-01
Fiscal End Date:
2021-06-30
Begin Assets:
$1,723,471.00
Revenue:
$2,152,175.00
Program Services:
$1,675,160.00
Expenses:
$1,840,656.00
End Assets:
$2,186,188.00
% To Program Services:
91%
Fiscal Begin Date:
2019-07-01
Fiscal End Date:
2020-06-30
Begin Assets:
$1,574,314.00
Revenue:
$1,464,941.00
Program Services:
$1,160,474.00
Expenses:
$1,315,533.00
End Assets:
$1,723,471.00
% To Program Services:
88%
Fiscal Begin Date:
2018-07-01
Fiscal End Date:
2019-06-30
Begin Assets:
$1,335,840.00
Revenue:
$1,572,510.00
Program Services:
$1,200,832.00
Expenses:
$1,390,557.00
End Assets:
$1,574,314.00
% To Program Services:
86%
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