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MENORAH MANOR, INC.

Company Details

Entity Name: MENORAH MANOR, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 30 Jun 1981 (44 years ago)
Document Number: 758978
FEI/EIN Number 592269292
Address: 255 59th Street N, St Petersburg, FL, 33710, US
Mail Address: 255 59th Street N, St Petersburg, FL, 33710, US
ZIP code: 33710
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1215394093 2016-01-25 2016-02-26 255 59TH ST N, ST PETERSBURG, FL, 337108539, US 255 59TH ST N, ST PETERSBURG, FL, 337108539, US

Contacts

Phone +1 727-302-3702
Fax 7273453957

Authorized person

Name MRS. DONNA PERRYMAN
Role CFO
Phone 7273023702

Taxonomy

Taxonomy Code 261QA0600X - Adult Day Care Clinic/Center
License Number 8869
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 014305500
State FL

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300U69VLLP6JV6S04 758978 US-FL GENERAL ACTIVE No data

Addresses

Legal C/O Goldstein, Robert, 255 59th Street North, St. Petersburg, US-FL, US, 33710
Headquarters 255 59th Street North, St. Petersburg, US-FL, US, 33710

Registration details

Registration Date 2014-08-19
Last Update 2023-08-04
Status LAPSED
Next Renewal 2019-02-14
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 758978

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MENORAH MANOR, INC. EMPLOYEE GROUP HEALTH AND WELFARE PLAN 2023 592269292 2024-11-27 MENORAH MANOR, INC. 143
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2016-06-01
Business code 623000
Sponsor’s telephone number 7273023702
Plan sponsor’s mailing address 255 59TH ST N, ST PETERSBURG, FL, 337108539
Plan sponsor’s address 255 59TH ST N, ST PETERSBURG, FL, 337108539

Number of participants as of the end of the plan year

Active participants 160
MENORAH MANOR, INC. RETIREMENT SAVINGS INCENTIVE PLAN 2009 592269292 2010-02-15 MENORAH MANOR, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-07-01
Business code 813000
Sponsor’s telephone number 7273452775
Plan sponsor’s mailing address 255 59TH STREET N., ST. PETERSBURG, FL, 33710
Plan sponsor’s address 255 59TH STREET N., ST. PETERSBURG, FL, 33710

Plan administrator’s name and address

Administrator’s EIN 592269292
Plan administrator’s name MENORAH MANOR, INC.
Plan administrator’s address 255 59TH STREET N., ST. PETERSBURG, FL, 33710
Administrator’s telephone number 7273452775

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2010-02-12
Name of individual signing DONNA PERRYMAN
Valid signature Filed with authorized/valid electronic signature
MENORAH MANOR, INC. RETIREMENT SAVINGS INCENTIVE PLAN 2009 592269292 2010-02-15 MENORAH MANOR, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-07-01
Business code 813000
Sponsor’s telephone number 7273452775
Plan sponsor’s mailing address 255 59TH STREET N., ST. PETERSBURG, FL, 33710
Plan sponsor’s address 255 59TH STREET N., ST. PETERSBURG, FL, 33710

Plan administrator’s name and address

Administrator’s EIN 592269292
Plan administrator’s name MENORAH MANOR, INC.
Plan administrator’s address 255 59TH STREET N., ST. PETERSBURG, FL, 33710
Administrator’s telephone number 7273452775

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2010-02-12
Name of individual signing DONNA PERRYMAN
Valid signature Filed with authorized/valid electronic signature
MENORAH MANOR, INC. RETIREMENT SAVINGS INCENTIVE PLAN 2009 592269292 2010-02-12 MENORAH MANOR, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-07-01
Business code 813000
Sponsor’s telephone number 7273452775
Plan sponsor’s mailing address 255 59TH STREET N., ST. PETERSBURG, FL, 33710
Plan sponsor’s address 255 59TH STREET N., ST. PETERSBURG, FL, 33710

Plan administrator’s name and address

Administrator’s EIN 592269292
Plan administrator’s name MENORAH MANOR, INC.
Plan administrator’s address 255 59TH STREET N., ST. PETERSBURG, FL, 33710
Administrator’s telephone number 7273452775

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2010-02-12
Name of individual signing DONNA PERRYMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PERRYMAN DONNA Agent 255 59TH ST N, SAINT PETERSBURG, FL, 33710

Chief Executive Officer

Name Role Address
Perryman Donna Chief Executive Officer 255 59th Street N, St Petersburg, FL, 33710

Vice Chairman

Name Role Address
Ludin Eric Esq. Vice Chairman 255 59th Street N, St Petersburg, FL, 33710

Treasurer

Name Role Address
Knowles Elizabeth Esq. Treasurer 255 59th St N, St Petersburg, FL, 33710

Secretary

Name Role Address
Soble Ann Secretary 255 59th St N, St Petersburg, FL, 33710

chai

Name Role Address
Delrahim David Esq. chai 255 59th Street N, St Petersburg, FL, 33710

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000025816 TOBY WEINMAN ASSISTED LIVING RESIDENCE AT MENORAH MANOR ACTIVE 2024-02-16 2029-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G24000025815 MENORAH MANOR ACTIVE 2024-02-16 2029-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G22000001090 MENORAH LIFE HOME CARE ACTIVE 2022-01-04 2027-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G22000001082 SAMSON NURSING CENTER ACTIVE 2022-01-04 2027-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G22000001088 RENEW YOU ACTIVE 2022-01-04 2027-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G22000001083 WEISSMAN DAY CENTER ACTIVE 2022-01-04 2027-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G22000001086 TOBY WEINMAN RESIDENCE ACTIVE 2022-01-04 2027-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G22000001077 MENORAH LIFE ACTIVE 2022-01-04 2027-12-31 No data 255 59TH ST N, ST PETERSBURG, FL, 33710
G15000117629 MARION AND BERNARD L. SAMSON NURSING CENTER ACTIVE 2015-11-19 2025-12-31 No data 255 59TH ST N, ST. PETERSBURG, FL, 33710--853

Events

Event Type Filed Date Value Description
AMENDMENT 2024-07-11 No data No data
MERGER 2019-12-05 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 700000198137
AMENDED AND RESTATEDARTICLES 2018-11-29 No data No data
AMENDED AND RESTATEDARTICLES 2003-06-25 No data No data
REINSTATEMENT 1994-09-19 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 1994-08-26 No data No data

Date of last update: 03 Jan 2025

Sources: Florida Department of State