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  5. PLAINFIELD SUPPORTIVE LIVING, LLC

PLAINFIELD SUPPORTIVE LIVING, LLC

Company Details

Entity Name: PLAINFIELD SUPPORTIVE LIVING, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 13 Jan 2005
Company Number: LLC_01398016
File Number: 01398016
Type of Management: Manager Managed
Date Status Change: 12 Dec 2024
Address 200 E COURT STREET, SUITE 400, KANKAKEE, 60901, IL
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
S8B1ZF99NP49 2025-02-15 14731 S VAN DYKE RD, PLAINFIELD, IL, 60544, 3185, USA 4882 N CONVENT STREET, BOURBONNAIS, IL, 60914, USA

Business Information
Congressional District 14
State/Country of Incorporation IL, USA
Activation Date 2024-02-20
Initial Registration Date 2021-05-13
Entity Start Date 2005-01-13
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name GREG ECHOLS
Role CFO
Address 4882 N CONVENT STREET, BOURBONNAIS, IL, 60914, USA
Government Business
Title PRIMARY POC
Name GREG ECHOLS
Role CFO
Address 4882 N CONVENT STREET, BOURBONNAIS, IL, 60914, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2022 273260998 2024-03-05 HERITAGE WOODS OF PLAINFIELD 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., SUITE E, BRADLEY, IL, 60915

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 2024-03-05
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2021 273260998 2023-10-23 HERITAGE WOODS OF PLAINFIELD 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., SUITE E, BRADLEY, IL, 60915

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 2023-10-23
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2021 273260998 2022-09-23 HERITAGE WOODS OF PLAINFIELD 26
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., SUITE E, BRADLEY, IL, 60915

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
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2020 273260998 2021-10-06 HERITAGE WOODS OF PLAINFIELD 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60915

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 2021-10-06
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2020 273260998 2021-09-17 HERITAGE WOODS OF PLAINFIELD 16
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60915

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 2021-09-17
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2019 273260998 2020-09-09 HERITAGE WOODS OF PLAINFIELD 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60915

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 2020-09-09
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2018 273260998 2020-01-24 HERITAGE WOODS OF PLAINFIELD 32
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60544

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 2020-01-24
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2018 273260998 2020-01-27 HERITAGE WOODS OF PLAINFIELD 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60544

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 2020-01-27
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2017 273260998 2018-10-05 HERITAGE WOODS OF PLAINFIELD 25
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60544

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF PLAINFIELD 401(K) PLAN 2017 273260998 2020-01-24 HERITAGE WOODS OF PLAINFIELD 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-09-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, PLAINFIELD, IL, 60544

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2020-01-24
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ROD BURKETT, 200 E COURT ST STE 400, KANKAKEE, 60901, SANGAMON Agent 2024-12-12

Manager

Name and Address Role Appointment Date
GARDANT MANAGEMENT SOLUTIONS INC., 200 E COURT STREET, SUITE 400, KANKAKEE, IL, 60901 Manager 2024-12-12

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
HERITAGE WOODS OF PLAINFIELD Assumed name 2011-06-17 No data No data 2019-12-16

Related by officers

ROD BURKETT, 200 E COURT ST STE 400, KANKAKEE, 60901, SANGAMON

PINE VIEW SUPPORTIVE LIVING FACILITY, LLC

GARDANT MANAGEMENT SOLUTIONS INC., 200 E COURT STREET, SUITE 400, KANKAKEE, IL, 60901

PINE VIEW SUPPORTIVE LIVING FACILITY, LLC BELVIDERE SLF DEVELOPMENT, LLC SPRING STREET MC, LLC

Related by address

200 E COURT STREET, SUITE 400, KANKAKEE, 60901, IL

SENIORS/BLOOMINGTON, LLC PINE VIEW SUPPORTIVE LIVING FACILITY, LLC BELVIDERE SLF DEVELOPMENT, LLC SPRING STREET MC, LLC PEORIA SLF SP, LLC SPRING STREET 1120 MC, LLC WILL COUNTY SLF MM, LLC WILL COUNTY SUPPORTIVE LIVING, LLC

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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