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  5. Minnesota Indian Primary Residential Treatment Center,Inc.

Minnesota Indian Primary Residential Treatment Center,Inc.

Company Details

Name: Minnesota Indian Primary Residential Treatment Center,Inc.
Jurisdiction: Minnesota
Legal type: Nonprofit Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 03 Jan 1977 (48 years ago)
Company Number: d3bbed7b-b5d4-e011-a886-001ec94ffe7f
File Number: O-1082
Registered Office Address: Rt 3 Box 66, Sawyer, MN 55780, USA
ZIP code: 55780
County: Carlton County
Place of Formation: Minnesota

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
N5LYGA7BAH16 2024-10-11 1150 MISSION RD, CLOQUET, MN, 55720, 3389, USA P O BOX 66, SAWYER, MN, 55780, 0066, USA

Business Information
Doing Business As MASHKAWISEN TREATMENT CENTER
URL mashkawisen.com
Congressional District 08
State/Country of Incorporation MN, USA
Activation Date 2023-10-30
Initial Registration Date 2004-12-15
Entity Start Date 1977-01-07
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 813410

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JAMES W MALLERY II
Address P O BOX 66, 1150 MISSION ROAD, CLOQUET, MN, 55720, USA
Title ALTERNATE POC
Name DESIRAE HERZUCK
Address P O BOX 66, 1150 MISSION ROAD, SAWYER, MN, 55780, 0066, USA
Government Business
Title PRIMARY POC
Name JAMES W MALLERY II
Address P O BOX 66, 1150 MISSION ROAD, CLOQUET, MN, 55720, USA
Past Performance
Title PRIMARY POC
Name JAMES W MALLERY II
Address P O BOX 66, 1150 MISSION ROAD, SAWYER, MN, 55780, 0066, USA
Title ALTERNATE POC
Name DESIRAE HERZUCK
Address P O BOX 66, 1150 MISSION ROAD, SAWYER, MN, 55780, 0066, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2021 411299061 2022-05-02 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 93
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address PO BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2022-05-02
Name of individual signing JAMES MALLERY
Valid signature Filed with authorized/valid electronic signature
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2021 411299061 2022-03-24 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 93
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address PO BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2022-03-24
Name of individual signing SANDRA MILLER
Valid signature Filed with authorized/valid electronic signature
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2020 411299061 2021-08-17 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 83
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address PO BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2021-08-17
Name of individual signing SANDRA MILLER
Valid signature Filed with authorized/valid electronic signature
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2018 411299061 2019-09-09 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 114
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address P.O. BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2019-09-09
Name of individual signing JAMES W. MALLERY II
Valid signature Filed with authorized/valid electronic signature
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2017 411299061 2018-09-25 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 90
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address P.O. BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2018-09-25
Name of individual signing JAMES W. MALLERY II
Valid signature Filed with authorized/valid electronic signature
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2016 411299061 2017-08-10 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 94
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address P.O. BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2017-08-10
Name of individual signing JAMES W. MALLERY II
Valid signature Filed with authorized/valid electronic signature
401(K) PLAN FOR EMPLOYEES OF MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 2015 411299061 2016-06-28 MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC. 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-04-01
Business code 621420
Sponsor’s telephone number 2188796731
Plan sponsor’s address P.O. BOX 66, SAWYER, MN, 55780

Signature of
Role Plan administrator
Date 2016-06-28
Name of individual signing MASHKAWISEN8
Valid signature Filed with authorized/valid electronic signature

President

Name Role Address
Floyd Jourdain, Jr President P O box 66, Sawyer, MN 55780, USA

Filing

Filing Name Filing date
Amendment - Nonprofit Corporation (Domestic) 2013-12-04
Registered Office and/or Agent - Nonprofit Corporation (Domestic) 1991-02-01
Original Filing - Nonprofit Corporation (Domestic) 1977-01-03
Nonprofit Corporation (Domestic) Business Name (Business Name: Minnesota Indian Primary Residential Treatment Center,Inc.) 1977-01-03

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 75H70524F06003 2024-09-17 2024-09-30 2028-09-30
Unique Award Key CONT_AWD_75H70524F06003_7527_75H70524D00007_7527
Awarding Agency Department of Health and Human Services
Link View Page

Award Amounts
Obligated Amount 26000.00
Current Award Amount 26000.00
Potential Award Amount 26000.00

Description
Title NON-RECURRING PY ALCOHOL AND SUBSTANCE ABUSE FUNDING END OF THE YEAR.
NAICS Code 621420: OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CENTERS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC.
UEI N5LYGA7BAH16
Recipient Address UNITED STATES, 1150 MISSION RD, CLOQUET, CARLTON, MINNESOTA, 55720
DELIVERY ORDER AWARD 75H70524F06002 2024-08-21 2024-09-30 2028-09-30
Unique Award Key CONT_AWD_75H70524F06002_7527_75H70524D00007_7527
Awarding Agency Department of Health and Human Services
Link View Page

Award Amounts
Obligated Amount 5153.00
Current Award Amount 5153.00
Potential Award Amount 5153.00

Description
Title THE PURPOSE OF THIS TASK ORDER IS TO ADD FY 2020 NON-RECURRING PY INFLATION FUNDING IN THE AMOUNT OF $5,153 PER BEHAVIORAL HEALTH PROGRAM.
NAICS Code 621420: OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CENTERS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC.
UEI N5LYGA7BAH16
Recipient Address UNITED STATES, 1150 MISSION RD, CLOQUET, CARLTON, MINNESOTA, 55720
No data IDV 75H70524D00007 2023-10-01 No data No data
Unique Award Key CONT_IDV_75H70524D00007_7527
Awarding Agency Department of Health and Human Services
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 3000000.00

Description
Title SUBSTANCE ABUSE FOR ELIGIBLE NATIVE AMERICAN BENEFICIARIES IN THE MINNESOTA AREA. CONTINUATION OF SUBSTANCE ABUSE SERVICES FOR THE ELIGIBLE NATIVE AMERICAN BENEFICIARIES IN THE METRO MINNEAPOLIS AREA FOR FY 2025 OCTOBER 01, 2024 TO SEPTEMBER 30. 20
NAICS Code 621420: OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CENTERS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient MINNESOTA INDIAN PRIMARY RESIDENTIAL TREATMENT CENTER, INC.
UEI N5LYGA7BAH16
Recipient Address UNITED STATES, 1150 MISSION RD, CLOQUET, CARLTON, MINNESOTA, 55720

Related by officers

Floyd Jourdain, Jr

RED LAKE LIMITED PARTNERSHIP #10

Related by address

No related companies by address

Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website

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