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| Plan Name | ST. JOSEPHS MANOR MEDICAL REIMBURSEMENT PLAN |
| Plan identification number | 507 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SAINT JOSEPH'S REHABILITATION AND RESIDENCE |
| Employer identification number (EIN): | 010339489 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 507 | 2009-01-01 | DAVID HAMLIN |
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