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  5. HOLLY NURSING CARE CENTER, INC.

HOLLY NURSING CARE CENTER, INC.

Company Details

Name: HOLLY NURSING CARE CENTER, INC.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 19 Oct 1981 (43 years ago)
Entity Number: 19871452353
ZIP code: 81047
County: Prowers County
Place of Formation: COLORADO
Principal Address: 320 N 8TH ST HOLLY CO 81047 US
Mailing Address: US

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
UXDJW1AKEKB8 2025-02-14 320 N 8TH ST, HOLLY, CO, 81047, 5023, USA PO BOX 636, HOLLY, CO, 81047, 0636, USA

Business Information
Doing Business As HOLLY NURSING CARE CENTER INC
Congressional District 04
State/Country of Incorporation CO, USA
Activation Date 2024-03-04
Initial Registration Date 2004-03-16
Entity Start Date 1981-12-11
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 623110

Points of Contacts
Electronic Business
Title PRIMARY POC
Name AMY PIERCE
Address PO BOX 636, 320 N. 8TH, HOLLY, CO, 81047, 0636, USA
Government Business
Title PRIMARY POC
Name AMY PIERCE
Address PO BOX 636, 320 N. 8TH, HOLLY, CO, 81047, 0636, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3SJF3 Active Non-Manufacturer 2004-03-16 2024-03-04 2029-03-04 2025-02-14

Contact Information
POC AMY PIERCE
Phone +1 719-537-6555
Fax +1 719-537-6366
Address 320 N 8TH ST, HOLLY, PROWERS, CO, 81047 5023, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HOLLY NURSING CARE CENTER INC. RETIREMENT PLAN 2013 840861809 2014-08-14 HOLLY NURSING CARE CENTER INC. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-12-01
Business code 623000
Sponsor’s telephone number 7209746205
Plan sponsor’s address 12136 W BAYAUD AVE STE 200, LAKEWOOD, CO, 80228

Signature of
Role Plan administrator
Date 2014-08-14
Name of individual signing TILLIE SCHIFFLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-14
Name of individual signing TILLIE SCHIFFLER
Valid signature Filed with authorized/valid electronic signature
HOLLY NURSING CARE CENTER, INC. RETIREMENT PLAN 2012 840861809 2013-07-30 HOLLY NURSING CARE CENTER, INC. 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-12-01
Business code 623000
Sponsor’s telephone number 7209746205
Plan sponsor’s address C/O RPS PLAN ADMINISTRATORS, 7100 E. BELLEVIEW AVE., SUITE 300, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 840861809
Plan administrator’s name HOLLY NURSING CARE CENTER
Plan administrator’s address 12136 W. BAYAUD AVE., SUITE 200, LAKEWOOD, CO, 80228
Administrator’s telephone number 7209746205

Signature of
Role Plan administrator
Date 2013-07-30
Name of individual signing JANICE O'KANE
Valid signature Filed with authorized/valid electronic signature
HOLLY NURSING CARE CENTER, INC. RETIREMENT PLAN 2011 840861809 2012-10-12 HOLLY NURSING CARE CENTER, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-12-01
Business code 623000
Sponsor’s telephone number 7209746205
Plan sponsor’s address C/O RPS PLAN ADMINISTRATORS, 7100 E. BELLEVIEW AVE., SUITE 300, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 840861809
Plan administrator’s name HOLLY NURSING CARE CENTER
Plan administrator’s address 12136 W. BAYAUD AVE., SUITE 200, LAKEWOOD, CO, 80228
Administrator’s telephone number 7209746205

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing JANICE O'KANE
Valid signature Filed with authorized/valid electronic signature
HOLLY NURSING CARE CENTER, INC. RETIREMENT PLAN 2010 840861809 2013-07-30 HOLLY NURSING CARE CENTER, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-12-01
Business code 623000
Sponsor’s telephone number 7209746205
Plan sponsor’s address C/O RPS PLAN ADMINISTRATORS, 7100 E. BELLEVIEW AVE., SUITE 300, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 840861809
Plan administrator’s name HOLLY NURSING CARE CENTER
Plan administrator’s address 12136 W. BAYAUD AVE., SUITE 200, LAKEWOOD, CO, 80228
Administrator’s telephone number 7209746205

Signature of
Role Plan administrator
Date 2013-07-30
Name of individual signing JANICE O'KANE
Valid signature Filed with authorized/valid electronic signature

Transaction History

Transaction ID Type Date Effective date Name Comment
20241483692 Statement of Change Changing the Registered Agent Information 2024-04-29 2024-04-29 No data Registered agent information changed;
20241442763 File Report 2024-04-23 2024-04-23 No data Change in registered agent information
20231440285 File Report 2023-04-25 2023-04-25 No data Change in registered agent information
20221485596 Statement Curing Delinquency 2022-05-13 2022-05-13 No data No data
20201819116 File Report 2020-09-23 2020-09-23 No data No data
20191765653 File Report 2019-09-24 2019-09-24 No data No data
20181749765 File Report 2018-09-24 2018-09-24 No data No data
20171732355 File Report 2017-09-27 2017-09-27 No data No data
20161651064 File Report 2016-09-26 2016-09-26 No data Change of Registered Agent
20151607232 File Report 2015-09-23 2015-09-23 No data Change of Registered Agent

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 36C25924K0401 2024-07-01 2024-07-31 2025-02-28
Unique Award Key CONT_AWD_36C25924K0401_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 23563.45
Current Award Amount 23563.45
Potential Award Amount 23563.45

Description
Title EXPRESS REPORT: JULY 2024
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0354 2024-06-01 2024-06-30 2025-02-28
Unique Award Key CONT_AWD_36C25924K0354_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 45102.62
Current Award Amount 45102.62
Potential Award Amount 45102.62

Description
Title EXPRESS REPORT: JUNE 2024
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0332 2024-05-01 2024-05-31 2025-02-28
Unique Award Key CONT_AWD_36C25924K0332_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 21296.84
Current Award Amount 21296.84
Potential Award Amount 21296.84

Description
Title EXPRESS REPORT: MAY 2024
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0275 2024-04-01 2024-04-30 2025-02-28
Unique Award Key CONT_AWD_36C25924K0275_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 20229.17
Current Award Amount 20229.17
Potential Award Amount 20229.17

Description
Title EXPRESS REPORT: APRIL 2024
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0232 2024-03-01 2024-03-31 2025-02-28
Unique Award Key CONT_AWD_36C25924K0232_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 13980.16
Current Award Amount 13980.16
Potential Award Amount 13980.16

Description
Title EXPRESS REPORT: MARCH 2024
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: MEDICAL- NURSING HOME CARE CONTRACTS

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0149 2024-01-01 2024-01-31 2025-02-28
Unique Award Key CONT_AWD_36C25924K0149_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 16999.87
Current Award Amount 16999.87
Potential Award Amount 16999.87

Description
Title EXPRESS REPORT: JANUARY 2024
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: MEDICAL- NURSING HOME CARE CONTRACTS

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0101 2023-12-01 2023-12-31 2025-02-28
Unique Award Key CONT_AWD_36C25924K0101_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 32489.88
Current Award Amount 32489.88
Potential Award Amount 32489.88

Description
Title EXPRESS REPORT: DECEMBER 2023
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: MEDICAL- NURSING HOME CARE CONTRACTS

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0056 2023-11-01 2023-11-30 2025-02-28
Unique Award Key CONT_AWD_36C25924K0056_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 56477.68
Current Award Amount 56477.68
Potential Award Amount 56477.68

Description
Title EXPRESS REPORT: NOVEMBER 2023
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: MEDICAL- NURSING HOME CARE CONTRACTS

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
DELIVERY ORDER AWARD 36C25924K0024 2023-10-01 2023-10-31 2025-02-28
Unique Award Key CONT_AWD_36C25924K0024_3600_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 39534.06
Current Award Amount 39534.06
Potential Award Amount 39534.06

Description
Title EXPRESS REPORT: OCTOBER 2023
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: MEDICAL- NURSING HOME CARE CONTRACTS

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000
No data IDV 36C25920D0036 2020-03-01 No data No data
Unique Award Key CONT_IDV_36C25920D0036_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 410796.00

Description
Title HOLLY NURSE CNH MEDICAID RATE ADJUSTMENT FY23 - EFFECTIVE 10-31-23
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: MEDICAL- NURSING HOME CARE CONTRACTS

Recipient Details
Recipient HOLLY NURSING CARE CENTER, INC.
UEI UXDJW1AKEKB8
Recipient Address UNITED STATES, 320 N 8TH ST, HOLLY, PROWERS, COLORADO, 810470000

Related by officers

No related officers

Related by address

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Date of last update: 23 Dec 2024

Sources: Colorado's Secretary of State

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