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MARTHA COKER CONVALESCENT HOME, INC.

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Company Details

Name: MARTHA COKER CONVALESCENT HOME, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 01 Mar 1994 (31 years ago)
Business ID: 605106
ZIP code: 39194
County: Yazoo
State of Incorporation: MISSISSIPPI
Principal Office Address: 401 E 9THYAZOO CITY, MS 39194

Agent

Name Role Address
Hoffman, Julie M Agent 401 East 9th Street, Yazoo City, MS 39194

Incorporator

Name Role Address
JEAN BASKIN Incorporator 401 E 9TH, YAZOO CITY, MS 39194

National Provider Identifier

NPI Number:
1174716179

Authorized Person:

Name:
MRS. JULIE M HOFFMAN
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
6627465709
Fax:
6627464621

Form 5500 Series

Employer Identification Number (EIN):
640849674
Plan Year:
2018
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
2
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Amendment Form Filed 2004-11-12 Amendment
Amendment Form Filed 2003-12-12 Amendment
See File Filed 1994-12-09 See File
Name Reservation Form Filed 1994-03-01 Name Reservation

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Date of last update: 18 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website