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  5. HERITAGE WOODS OF DEKALB, LLC

HERITAGE WOODS OF DEKALB, LLC

Company Details

Entity Name: HERITAGE WOODS OF DEKALB, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 14 Sep 2006
Company Number: LLC_01967959
File Number: 01967959
Type of Management: Manager Managed
Date Status Change: 19 Aug 2024
Address 4882 N. CONVENT ST., BOURBONNAIS, 60914, IL
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
N8S8PJ4QF6G4 2025-02-13 2626 N ANNIE GLIDDEN RD, DEKALB, IL, 60115, 1106, USA 4882 N CONVENT STREET, BOURBONNAIS, IL, 60914, USA

Business Information
Congressional District 14
State/Country of Incorporation IL, USA
Activation Date 2024-02-16
Initial Registration Date 2021-05-13
Entity Start Date 2006-12-08
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 DEKALB 401(K) PLAN 2022 260443680 2024-03-05 HERITAGE WOODS OF DEKALB 21
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 DEKALB 401(K) PLAN 2021 260443680 2022-10-03 HERITAGE WOODS OF DEKALB 21
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 2022-10-03
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2020 260443680 2021-09-29 HERITAGE WOODS OF DEKALB 21
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 2021-09-29
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2020 260443680 2021-09-17 HERITAGE WOODS OF DEKALB 21
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 2021-09-17
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2019 260443680 2020-09-08 HERITAGE WOODS OF DEKALB 18
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 2020-09-08
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2018 260443680 2020-01-24 HERITAGE WOODS OF DEKALB 21
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 2020-01-24
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2018 260443680 2020-01-27 HERITAGE WOODS OF DEKALB 21
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 2020-01-27
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2017 260443680 2019-12-02 HERITAGE WOODS OF DEKALB 21
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2019-12-02
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2017 260443680 2018-12-07 HERITAGE WOODS OF DEKALB 21
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2018-12-07
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
HERITAGE WOODS OF DEKALB 401(K) PLAN 2017 260443680 2018-10-05 HERITAGE WOODS OF DEKALB 21
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E NORTH ST., STE 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 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

Agent

Name and Address Role Appointment Date
ROD BURKETT, 4882 N. CONVENT ST., BOURBONNAIS, 60914, KANKAKEE Agent 2019-10-24

Manager

Name and Address Role Appointment Date
PINE VIEW SUPPORTIVE LIVING FACILITY, LLC, 4882 N. CONVENT ST., BOURBONNAIS, IL, 60914 Manager 2019-10-24

Related by officers

ROD BURKETT, 4882 N. CONVENT ST., BOURBONNAIS, 60914, KANKAKEE

HERITAGE WOODS SLF OF MOLINE, LLC HW DEKALB II, LLC HW BOLINGBROOK SERVICE PROVIDER, LLC PLAINFIELD SUPPORTIVE LIVING MANAGER, LLC

Related by address

4882 N. CONVENT ST., BOURBONNAIS, 60914, IL

HERITAGE WOODS/BENTON, LLC SENIORS EQUITIES LLC HERITAGE WOODS OF SOUTH ELGIN, LLC HERITAGE WOODS SLF OF MOLINE, LLC FREEPORT SUPPORTIVE LIVING, LLC HERITAGE WOODS OF HUNTLEY, LLC THE VILLAS AT CENTRALIA, LLC HW DEKALB II, LLC HERITAGE WOODS OF BATAVIA, LLC

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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