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  5. HEARTLAND RURAL HEALTH NETWORK, INC.

HEARTLAND RURAL HEALTH NETWORK, INC.

Company Details

Entity Name: HEARTLAND RURAL HEALTH NETWORK, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 27 Dec 1993 (31 years ago)
Last Event: AMENDMENT
Event Date Filed: 12 Feb 1996 (29 years ago)
Document Number: N93000005791
FEI/EIN Number 65-0462144
Address: 435 S Pine St, SEBRING, FL 33870
Mail Address: 435 S Pine St, SEBRING, FL 33870
ZIP code: 33870
County: Highlands
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HEARTLAND RURAL HEALTH NETWORK 403(B) 2022 650462144 2023-10-15 HEARTLAND RURAL HEALTH NETWORK, INC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Plan sponsor’s address 435 S PINE ST, SEBRING, FL, 338703647

Signature of
Role Plan administrator
Date 2023-10-14
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-14
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2021 650462144 2022-10-05 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Plan sponsor’s address 435 S PINE ST, SEBRING, FL, 338703647

Signature of
Role Plan administrator
Date 2022-09-30
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-30
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2020 650462144 2021-08-16 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Plan sponsor’s address 435 S PINE ST, SEBRING, FL, 338703647

Signature of
Role Plan administrator
Date 2021-08-16
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-08-16
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2019 650462144 2020-09-10 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Plan sponsor’s address 435 S PINE ST, SEBRING, FL, 338703647

Signature of
Role Plan administrator
Date 2020-09-10
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-10
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2018 650462144 2019-09-25 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Plan sponsor’s address 435 S PINE ST, SEBRING, FL, 338703647

Signature of
Role Plan administrator
Date 2019-09-25
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-25
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2017 650462144 2018-09-21 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Plan sponsor’s address 1200 W AVON BLVD, AVON PARK, FL, 338258343

Signature of
Role Plan administrator
Date 2018-09-21
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-21
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2016 650462144 2017-07-17 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Sponsor’s telephone number 8634526530
Plan sponsor’s address 1200 W AVON BLVD, AVON PARK, FL, 338258343

Signature of
Role Plan administrator
Date 2017-07-17
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-17
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403 (B) 2015 650462144 2016-07-25 HEARTLAND RURAL HEALTH NETWORK, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Sponsor’s telephone number 8634526530
Plan sponsor’s address 1200 W AVON BLVD, AVON PARK, FL, 338258343

Signature of
Role Plan administrator
Date 2016-07-25
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-25
Name of individual signing MELISSA THIBODEAU
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403 (B) 2014 650462144 2015-09-24 HEARTLAND RURAL HEALTH NETWORK, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Sponsor’s telephone number 8634526530
Plan sponsor’s address 1200 WEST AVON BLVD, AVON PARK, FL, 33825

Signature of
Role Plan administrator
Date 2015-09-24
Name of individual signing KELLY JOHNSON
Valid signature Filed with authorized/valid electronic signature
HEARTLAND RURAL HEALTH NETWORK 403(B) 2013 650462144 2014-09-25 HEARTLAND RURAL HEALTH NETWORK, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621410
Sponsor’s telephone number 8634526530
Plan sponsor’s address 1200 WEST AVON BLVD, AVON PARK, FL, 33825

Plan administrator’s name and address
Administrator’s EIN 650462144
Plan administrator’s name HEARTLAND RURAL HEALTH NETWORK, INC
Plan administrator’s address 1200 WEST AVON BLVD, AVON PARK, FL, 33825
Administrator’s telephone number 8634526530

Agent

Name Role Address
Carrasquillo, Valeria Agent 435 S Pine St, Sebring, FL 33870

President

Name Role Address
Warren, Blake President 328 S. Central Ave., Apopka, FL 32703

Director

Name Role Address
Warren, Blake Director 328 S. Central Ave., Apopka, FL 32703
Rihn, Robert C Director 2026 Crystal Wood Drive, Lakeland, FL 33801
Murphy, Holly Director P.O. Box 1289, Tampa, FL 33601
Sica, Vincent A. Director 900 North Robert Ave., PO Box 2180 Arcadia, FL 34265
Collazo, Denise Director 950 C.R. 17A West, Avon Park, FL 33825
Casey, Kristin Director 435 Pine St., Sebring, FL 33870
Phillips, Tatiana Director 435 Pine St., Sebring, FL 33870
Hoerner, Kerry Director 435 Pine St., Sebring, FL 33870

Secretary

Name Role Address
Murphy, Holly Secretary P.O. Box 1289, Tampa, FL 33601

Treasurer

Name Role Address
Murphy, Holly Treasurer P.O. Box 1289, Tampa, FL 33601

Vice President

Name Role Address
Sica, Vincent A. Vice President 900 North Robert Ave., PO Box 2180 Arcadia, FL 34265

Executive Program Director

Name Role Address
Carrasquillo, Valeria Executive Program Director 435 Pine St., Sebring, FL 33870

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-02-06 Carrasquillo, Valeria No data
REGISTERED AGENT ADDRESS CHANGED 2024-02-06 435 S Pine St, Sebring, FL 33870 No data
CHANGE OF PRINCIPAL ADDRESS 2020-01-17 435 S Pine St, SEBRING, FL 33870 No data
CHANGE OF MAILING ADDRESS 2020-01-17 435 S Pine St, SEBRING, FL 33870 No data
AMENDMENT 1996-02-12 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-30
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-01-11
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-03-10
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-02-01
ANNUAL REPORT 2018-03-07
ANNUAL REPORT 2017-01-16
ANNUAL REPORT 2016-01-15

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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