Is Origin Health LLC active?

Yes — the South Dakota registry lists Origin Health LLC as active, as of the 2026-06-16 source snapshot. The status is republished verbatim from the Secretary of State record.

Where is Origin Health LLC registered?

Origin Health LLC is registered in South Dakota under company number DL314045, first registered on November 19, 2025.

What type of company is Origin Health LLC?

Origin Health LLC is registered as an LLC with the South Dakota Secretary of State.

How many employees does Origin Health LLC have?

Origin Health LLC has an estimated 8 employees as of plan year 2024 — a modeled figure derived from the retirement-plan participant counts in its DOL Form 5500 filings, not an official headcount.

Does Origin Health LLC offer a 401(k) plan?

Yes — Form 5500 filings with the Department of Labor show Origin Health LLC sponsors a 401(k) retirement plan. Filings span 2019–2024. Details are in the Form 5500 section above.

Does Origin Health LLC have UCC liens?

No UCC financing statements name Origin Health LLC as debtor in the indexed state registries.

Is Origin Health LLC a federal contractor?

Origin Health LLC appears in 2 federal recipient records (SAM.gov), indicating registration to receive federal awards. Obligation totals are not available for these records.

Does Origin Health LLC hold any licenses?

12 license and credential records are matched to Origin Health LLC. Each license, its type and issuing authority is listed in the Licenses section above.

What is the EIN of Origin Health LLC?

The Employer Identification Number (EIN) on record for Origin Health LLC is 821573223.

What public records are linked to Origin Health LLC?

18 public records are linked to Origin Health LLC: 1 in Filings, 12 in Licenses & authorities, 2 in Loans, 3 in 401(k) — matched across federal, state and municipal registers by its registered legal names.

Where does this data come from?

Every fact on this profile is republished from official public registers — Secretary of State filings, UCC indexes and federal datasets. Each section names its issuing register and the snapshot Netstate last retrieved (latest: 2026-06-16).

Origin Health LLC — South Dakota LLC No. DL314045: Active, 1 filing

Origin Health LLC is a South Dakota LLC, registered on November 19, 2025. It is based at 25 First Ave. Sw Ste A, Watertown, SD, 57201. The company is currently listed as active on the South Dakota register, is registered under company number DL314045 and carries EIN 821573223. Public records for the company include 1 SoS registration, 2 federal contracts, 2 loan records, 12 Medicare provider records and 3 Form 5500 filings. Every fact here is republished from an official public register and traces back to a primary source document.

Legal entity name	Origin Health LLC
Principal address	25 First Ave. Sw Ste AWatertown57201SDUnited States
Registration state	South Dakota
Status	Active
Registered	19 November 2025 (9 months ago)
Entity type	LLC
Standing	compliant
Company number	DL314045
EIN	821573223
Employees (modeled)	≈8 employees2024
Registered agent	NORTHWEST REGISTERED AGENT, LLC
Source registry	South Dakota Secretary of State · updated 15 June 2026

Public records	1 SoS registration

Est. revenue (modeled)	$1.2M2024
Federal contractor	Yes · 2 federal recipient records (SAM)
SBA loans	$72K · approved amounts

State	Business name	Filed	Registered agent	Officers	Status
South DakotaTHIS	Origin Health LLC	2025-11-19	NORTHWEST REGISTERED AGENT, LLC	—	Active
Filing ID DL314045 Jurisdiction Domestic · LLC Principal address 25 First Ave. Sw Ste A, Watertown, SD, 57201 Registered agent NORTHWEST REGISTERED AGENT, LLC25 FIRST AVENUE SW STE A, WATERTOWN, SD, 57201 Officers Not reported

State	License / ID	Type	Issued	Status
—	1841835113	Medicare / NPI provider	11/11/2019	Unknown
credential — deactivation date — entity type code 2 enumeration date 11/11/2019 first name — last name — last update date 06/23/2020 mailing address 1 2831 FORT MISSOULA RD STE 232 mailing address 2 — mailing city MISSOULA mailing country US mailing postal code 598047479 mailing state MT middle name — npi 1841835113 organization name ORIGIN HEALTH LLC practice address 1 2831 FORT MISSOULA RD STE 232 practice city MISSOULA practice postal code 598047479 practice state MT reactivation date — taxonomy code 1 207V00000X Source: NPI registry · document npi/
—	1104700897	Medicare / NPI provider	08/05/2025	Unknown
credential — deactivation date — entity type code 2 enumeration date 08/05/2025 first name — last name — last update date 08/05/2025 mailing address 1 2831 FORT MISSOULA RD STE 232 mailing address 2 — mailing city MISSOULA mailing country US mailing postal code 598047479 mailing state MT middle name — npi 1104700897 organization name ORIGIN HEALTH LLC practice address 1 2831 FORT MISSOUA ROAD practice city MISSOULA practice postal code 59804 practice state MT reactivation date — taxonomy code 1 261QB0400X Source: NPI registry · document npi/
Montana	1104053859	OBSTETRICS/GYNECOLOGY	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential MD facility name ORIGIN HEALTH LLC first name LEAH gender F graduation year 2009 group accepts assignment Y individual accepts assignment Y individual enrollment id I20160129000575 individual pac id 2264673078 last name MILLER medical school UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE middle name ANN npi 1104053859 num organization members 10 organization pac id 8325465487 primary specialty OBSTETRICS/GYNECOLOGY secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1134225964	GYNECOLOGICAL ONCOLOGY	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential MD facility name ORIGIN HEALTH LLC first name MARIA gender F graduation year 1992 group accepts assignment Y individual accepts assignment Y individual enrollment id I20100304000528 individual pac id 7810981644 last name HUNTLEY medical school SANFORD SCHOOL OF MEDICINE OF UNIVERSITY OF SOUTH DAKOTA middle name L npi 1134225964 num organization members 10 organization pac id 8325465487 primary specialty GYNECOLOGICAL ONCOLOGY secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1194409334	CERTIFIED NURSE MIDWIFE (CNM)	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential CNM facility name ORIGIN HEALTH LLC first name BRITTANY gender F graduation year 2023 group accepts assignment Y individual accepts assignment Y individual enrollment id I20230824002841 individual pac id 1658734538 last name ROSS medical school OTHER middle name — npi 1194409334 num organization members 10 organization pac id 8325465487 primary specialty CERTIFIED NURSE MIDWIFE (CNM) secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1316982044	OBSTETRICS/GYNECOLOGY	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential MD facility name ORIGIN HEALTH LLC first name JULIE gender F graduation year 1997 group accepts assignment Y individual accepts assignment Y individual enrollment id I20040119000543 individual pac id 6305746041 last name KUYKENDALL medical school UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE middle name L npi 1316982044 num organization members 10 organization pac id 8325465487 primary specialty OBSTETRICS/GYNECOLOGY secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1649418930	NURSE PRACTITIONER	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential NP facility name ORIGIN HEALTH LLC first name CASSIE gender F graduation year 2022 group accepts assignment Y individual accepts assignment Y individual enrollment id I20220909000903 individual pac id 5092190181 last name BRONSON medical school GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE middle name JO npi 1649418930 num organization members 10 organization pac id 8325465487 primary specialty NURSE PRACTITIONER secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1871525337	OBSTETRICS/GYNECOLOGY	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential MD facility name ORIGIN HEALTH LLC first name KEITH gender M graduation year 1992 group accepts assignment Y individual accepts assignment Y individual enrollment id I20160309000834 individual pac id 0143398982 last name BALDERSTON medical school OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE middle name DOUGLAS npi 1871525337 num organization members 10 organization pac id 8325465487 primary specialty OBSTETRICS/GYNECOLOGY secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1952079204	CERTIFIED NURSE MIDWIFE (CNM)	—	Unknown
address id MT598047479MI2831XRDXX405 address line 1 2831 FORT MISSOULA RD address line 2 SUITE 232 address line 2 suppressed — city MISSOULA credential CNM facility name ORIGIN HEALTH LLC first name STEPHANIE gender F graduation year 2021 group accepts assignment Y individual accepts assignment Y individual enrollment id I20211118001873 individual pac id 8820487515 last name LIGHTER medical school OTHER middle name LYNN npi 1952079204 num organization members 10 organization pac id 8325465487 primary specialty CERTIFIED NURSE MIDWIFE (CNM) secondary specialty 1 — secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all — state MT suffix — telehealth — telephone number 4065235650 zip code 598047479 Source: CMS medicare providers · document cms-medicare/
Montana	1659403038	UNDEFINED PHYSICIAN TYPE (SPECIFY)	—	Unknown
address id MT597011515BU225XXSTXX400 address line 1 225 S CLARK ST address line 2 — address line 2 suppressed — city BUTTE credential MD facility name ORIGIN HEALTH LLC first name MERLIN gender M graduation year 1993 group accepts assignment Y individual accepts assignment Y individual enrollment id I20201023002715 individual pac id 9638398266 last name FAUSETT medical school UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED middle name BARDETT npi 1659403038 num organization members 10 organization pac id 8325465487 primary specialty UNDEFINED PHYSICIAN TYPE (SPECIFY) secondary specialty 1 OBSTETRICS/GYNECOLOGY secondary specialty 2 — secondary specialty 3 — secondary specialty 4 — secondary specialty all OBSTETRICS/GYNECOLOGY state MT suffix — telehealth — telephone number 4062211195 zip code 597011515 Source: CMS medicare providers · document cms-medicare/

State

License / ID

Type

Issued

Status

—

1841835113

Medicare / NPI provider

11/11/2019

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

11/11/2019

first name

—

last name

—

last update date

06/23/2020

mailing address 1

2831 FORT MISSOULA RD STE 232

mailing address 2

—

mailing city

MISSOULA

mailing country

mailing postal code

598047479

mailing state

middle name

—

npi

1841835113

organization name

ORIGIN HEALTH LLC

practice address 1

2831 FORT MISSOULA RD STE 232

practice city

MISSOULA

practice postal code

598047479

practice state

reactivation date

—

taxonomy code 1

207V00000X

Source: NPI registry · document npi/

—

1104700897

Medicare / NPI provider

08/05/2025

Unknown

credential

—

deactivation date

—

entity type code

enumeration date

08/05/2025

first name

—

last name

—

last update date

08/05/2025

mailing address 1

2831 FORT MISSOULA RD STE 232

mailing address 2

—

mailing city

MISSOULA

mailing country

mailing postal code

598047479

mailing state

middle name

—

npi

1104700897

organization name

ORIGIN HEALTH LLC

practice address 1

2831 FORT MISSOUA ROAD

practice city

MISSOULA

practice postal code

59804

practice state

reactivation date

—

taxonomy code 1

261QB0400X

Source: NPI registry · document npi/

Montana

1104053859

OBSTETRICS/GYNECOLOGY

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

facility name

ORIGIN HEALTH LLC

first name

LEAH

gender

graduation year

2009

group accepts assignment

individual accepts assignment

individual enrollment id

I20160129000575

individual pac id

2264673078

last name

MILLER

medical school

UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE

middle name

ANN

npi

1104053859

num organization members

organization pac id

8325465487

primary specialty

OBSTETRICS/GYNECOLOGY

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1134225964

GYNECOLOGICAL ONCOLOGY

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

facility name

ORIGIN HEALTH LLC

first name

MARIA

gender

graduation year

1992

group accepts assignment

individual accepts assignment

individual enrollment id

I20100304000528

individual pac id

7810981644

last name

HUNTLEY

medical school

SANFORD SCHOOL OF MEDICINE OF UNIVERSITY OF SOUTH DAKOTA

middle name

npi

1134225964

num organization members

organization pac id

8325465487

primary specialty

GYNECOLOGICAL ONCOLOGY

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1194409334

CERTIFIED NURSE MIDWIFE (CNM)

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

CNM

facility name

ORIGIN HEALTH LLC

first name

BRITTANY

gender

graduation year

2023

group accepts assignment

individual accepts assignment

individual enrollment id

I20230824002841

individual pac id

1658734538

last name

ROSS

medical school

OTHER

middle name

—

npi

1194409334

num organization members

organization pac id

8325465487

primary specialty

CERTIFIED NURSE MIDWIFE (CNM)

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1316982044

OBSTETRICS/GYNECOLOGY

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

facility name

ORIGIN HEALTH LLC

first name

JULIE

gender

graduation year

1997

group accepts assignment

individual accepts assignment

individual enrollment id

I20040119000543

individual pac id

6305746041

last name

KUYKENDALL

medical school

UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE

middle name

npi

1316982044

num organization members

organization pac id

8325465487

primary specialty

OBSTETRICS/GYNECOLOGY

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1649418930

NURSE PRACTITIONER

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

facility name

ORIGIN HEALTH LLC

first name

CASSIE

gender

graduation year

2022

group accepts assignment

individual accepts assignment

individual enrollment id

I20220909000903

individual pac id

5092190181

last name

BRONSON

medical school

GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE

middle name

npi

1649418930

num organization members

organization pac id

8325465487

primary specialty

NURSE PRACTITIONER

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1871525337

OBSTETRICS/GYNECOLOGY

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

facility name

ORIGIN HEALTH LLC

first name

KEITH

gender

graduation year

1992

group accepts assignment

individual accepts assignment

individual enrollment id

I20160309000834

individual pac id

0143398982

last name

BALDERSTON

medical school

OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE

middle name

DOUGLAS

npi

1871525337

num organization members

organization pac id

8325465487

primary specialty

OBSTETRICS/GYNECOLOGY

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1952079204

CERTIFIED NURSE MIDWIFE (CNM)

—

Unknown

address id

MT598047479MI2831XRDXX405

address line 1

2831 FORT MISSOULA RD

address line 2

SUITE 232

address line 2 suppressed

—

city

MISSOULA

credential

CNM

facility name

ORIGIN HEALTH LLC

first name

STEPHANIE

gender

graduation year

2021

group accepts assignment

individual accepts assignment

individual enrollment id

I20211118001873

individual pac id

8820487515

last name

LIGHTER

medical school

OTHER

middle name

LYNN

npi

1952079204

num organization members

organization pac id

8325465487

primary specialty

CERTIFIED NURSE MIDWIFE (CNM)

secondary specialty 1

—

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

—

state

suffix

—

telehealth

—

telephone number

4065235650

zip code

598047479

Source: CMS medicare providers · document cms-medicare/

Montana

1659403038

UNDEFINED PHYSICIAN TYPE (SPECIFY)

—

Unknown

address id

MT597011515BU225XXSTXX400

address line 1

225 S CLARK ST

address line 2

—

address line 2 suppressed

—

city

BUTTE

credential

facility name

ORIGIN HEALTH LLC

first name

MERLIN

gender

graduation year

1993

group accepts assignment

individual accepts assignment

individual enrollment id

I20201023002715

individual pac id

9638398266

last name

FAUSETT

medical school

UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED

middle name

BARDETT

npi

1659403038

num organization members

organization pac id

8325465487

primary specialty

UNDEFINED PHYSICIAN TYPE (SPECIFY)

secondary specialty 1

OBSTETRICS/GYNECOLOGY

secondary specialty 2

—

secondary specialty 3

—

secondary specialty 4

—

secondary specialty all

OBSTETRICS/GYNECOLOGY

state

suffix

—

telehealth

—

telephone number

4062211195

zip code

597011515

Source: CMS medicare providers · document cms-medicare/

Amount	Approved	Lender	Jobs	Status
$20,353	05/19/2020	Synovus Bank	3	Paid in Full
borrower address 35136 US HIGHWAY 19 N borrower city PALM HARBOR borrower name ORIGIN HEALTH LLC borrower state FL borrower zip 34684-1929 business age description Existing or more than 2 years old business type Limited Liability Company(LLC) congressional district FL-13 current approval amount 20353.12 date approved 05/19/2020 debt interest proceed — ethnicity Unknown/NotStated forgiveness amount 20516.5 forgiveness date 03/09/2021 franchise name — gender Unanswered health care proceed — hubzone indicator N initial approval amount 20353.12 jobs reported 3 lmi indicator N loan number 8759957402 loan status Paid in Full loan status date 04/21/2021 mortgage interest proceed — naics code 541720 non profit — originating lender Synovus Bank originating lender city COLUMBUS originating lender location id 19248 originating lender state GA payroll proceed 20353.12 processing method PPP project city PALM HARBOR project county name PINELLAS project state FL project zip 34684-1929 race Unanswered refinance eidl proceed — rent proceed — rural urban indicator U sba guaranty percentage 100 sba office code 0455 servicing lender address 1148 Broadway servicing lender city COLUMBUS servicing lender location id 19248 servicing lender name Synovus Bank servicing lender state GA servicing lender zip 31901-2429 term 24 undisbursed amount 0 utilities proceed — veteran Unanswered Source: SBA PPP loans · document sba-ppp/8759957402
$51,500	04/05/2020	TrailWest Bank	10	Paid in Full
borrower address 3405 RAVENWOOD LN borrower city MISSOULA borrower name ORIGIN HEALTH LLC borrower state MT borrower zip 59803-3219 business age description New Business or 2 years or less business type Limited Liability Company(LLC) congressional district MT-01 current approval amount 51500 date approved 04/05/2020 debt interest proceed — ethnicity Not Hispanic or Latino forgiveness amount 51883.78 forgiveness date 01/08/2021 franchise name — gender Male Owned health care proceed — hubzone indicator N initial approval amount 51500 jobs reported 10 lmi indicator N loan number 5374287005 loan status Paid in Full loan status date 02/20/2021 mortgage interest proceed — naics code 622110 non profit — originating lender TrailWest Bank originating lender city LOLO originating lender location id 41962 originating lender state MT payroll proceed 51500 processing method PPP project city MISSOULA project county name MISSOULA project state MT project zip 59803-3219 race White refinance eidl proceed — rent proceed — rural urban indicator U sba guaranty percentage 100 sba office code 0885 servicing lender address 11300 US Hwy 93 South, Ste D servicing lender city LOLO servicing lender location id 41962 servicing lender name TrailWest Bank servicing lender state MT servicing lender zip 59847-9806 term 24 undisbursed amount 0 utilities proceed — veteran Unanswered Source: SBA PPP loans · document sba-ppp/5374287005

Amount

Approved

Lender

Jobs

Status

$20,353

05/19/2020

Synovus Bank

Paid in Full

borrower address

35136 US HIGHWAY 19 N

borrower city

PALM HARBOR

borrower name

ORIGIN HEALTH LLC

borrower state

borrower zip

34684-1929

business age description

Existing or more than 2 years old

business type

Limited Liability Company(LLC)

congressional district

FL-13

current approval amount

20353.12

date approved

05/19/2020

debt interest proceed

—

ethnicity

Unknown/NotStated

forgiveness amount

20516.5

forgiveness date

03/09/2021

franchise name

—

gender

Unanswered

health care proceed

—

hubzone indicator

initial approval amount

20353.12

jobs reported

lmi indicator

loan number

8759957402

loan status

Paid in Full

loan status date

04/21/2021

mortgage interest proceed

—

naics code

541720

non profit

—

originating lender

Synovus Bank

originating lender city

COLUMBUS

originating lender location id

19248

originating lender state

payroll proceed

20353.12

processing method

PPP

project city

PALM HARBOR

project county name

PINELLAS

project state

project zip

34684-1929

race

Unanswered

refinance eidl proceed

—

rent proceed

—

rural urban indicator

sba guaranty percentage

100

sba office code

0455

servicing lender address

1148 Broadway

servicing lender city

COLUMBUS

servicing lender location id

19248

servicing lender name

Synovus Bank

servicing lender state

servicing lender zip

31901-2429

term

undisbursed amount

utilities proceed

—

veteran

Unanswered

Source: SBA PPP loans · document sba-ppp/8759957402

$51,500

04/05/2020

TrailWest Bank

Paid in Full

borrower address

3405 RAVENWOOD LN

borrower city

MISSOULA

borrower name

ORIGIN HEALTH LLC

borrower state

borrower zip

59803-3219

business age description

New Business or 2 years or less

business type

Limited Liability Company(LLC)

congressional district

MT-01

current approval amount

51500

date approved

04/05/2020

debt interest proceed

—

ethnicity

Not Hispanic or Latino

forgiveness amount

51883.78

forgiveness date

01/08/2021

franchise name

—

gender

Male Owned

health care proceed

—

hubzone indicator

initial approval amount

51500

jobs reported

lmi indicator

loan number

5374287005

loan status

Paid in Full

loan status date

02/20/2021

mortgage interest proceed

—

naics code

622110

non profit

—

originating lender

TrailWest Bank

originating lender city

LOLO

originating lender location id

41962

originating lender state

payroll proceed

51500

processing method

PPP

project city

MISSOULA

project county name

MISSOULA

project state

project zip

59803-3219

race

White

refinance eidl proceed

—

rent proceed

—

rural urban indicator

sba guaranty percentage

100

sba office code

0885

servicing lender address

11300 US Hwy 93 South, Ste D

servicing lender city

LOLO

servicing lender location id

41962

servicing lender name

TrailWest Bank

servicing lender state

servicing lender zip

59847-9806

term

undisbursed amount

utilities proceed

—

veteran

Unanswered

Source: SBA PPP loans · document sba-ppp/5374287005

Employees (modeled)	≈8 · plan year 2024
Est. annual revenue (modeled)	$1.2M
Benefit plans	401(k) plan on file · plan terminated
Filing history	6 plan years filed, 2019–2024
Sponsor EIN	82-1573223

Employees (modeled)

≈8 · plan year 2024

Est. annual revenue (modeled)

$1.2M

Benefit plans

401(k) plan on file · plan terminated

Filing history

6 plan years filed, 2019–2024

Sponsor EIN

82-1573223

Plan year	Employees (est.)	Participants	Plan assets	Revenue (est.)	401(k)
2024	≈8	11 (7 active)	—	$1.2M	401(k)
active participants 7 admin name GUIDELINE RK, LLC ein 821573223 employees est 8 employer contrib usd 0 estimate method v1-uncalibrated-2026-08-17 final filings 1 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis active headcount suspect false is operating employer true last received 2025-03-17 naics 621399 naics rpe level 621399 naics rpe usd 152112.8 name ORIGIN HEALTH participant contrib usd 0 plan assets usd 0 plan count 1 revenue est headcount usd 1216902 revenue est usd 1216902 signer name QIAN LIU state FL total participants 11 year 2024 Source: DOL Form 5500 series (EBSA) · plan year 2024 · EIN 82-1573223
2023	≈8	7 (7 active)	$139,925	$1.4M	401(k)
active participants 7 admin name GUIDELINE, INC. ein 821573223 employees est 8 employer contrib usd 12898 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis active headcount suspect false is operating employer true last received 2024-05-07 naics 621399 naics rpe level 621399 naics rpe usd 152112.8 name ORIGIN HEALTH participant contrib usd 40840 payroll est usd 583429 plan assets usd 139925 plan count 1 revenue est headcount usd 1216902 revenue est payroll usd 1629689 revenue est usd 1408251 signer name QIAN LIU state FL total participants 7 year 2023 Source: DOL Form 5500 series (EBSA) · plan year 2023 · EIN 82-1573223
2022	≈3	4 (3 active)	$68,390	$728,459	401(k)
active participants 3 admin name GUIDELINE, INC. ein 821573223 employees est 3 employer contrib usd 8588 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis active headcount suspect false is operating employer true last received 2023-05-26 naics 621399 naics rpe level 621399 naics rpe usd 152112.8 name ORIGIN HEALTH participant contrib usd 29141 payroll est usd 416300 plan assets usd 68390 plan count 1 revenue est headcount usd 456338 revenue est payroll usd 1162849 revenue est usd 728459 signer name CHRISTINE RIMER state FL total participants 4 year 2022 Source: DOL Form 5500 series (EBSA) · plan year 2022 · EIN 82-1573223
2021	≈2	2 (2 active)	$39,894	$509,271	401(k)
active participants 2 admin name GUIDELINE, INC. ein 821573223 employees est 2 employer contrib usd 3419 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis active headcount suspect false is operating employer true last received 2022-06-01 naics 621399 naics rpe level 621399 naics rpe usd 152112.8 name ORIGIN HEALTH participant contrib usd 21364 payroll est usd 305200 plan assets usd 39894 plan count 1 revenue est headcount usd 304226 revenue est payroll usd 852514 revenue est usd 509271 signer name CHRISTINE RIMER state FL total participants 2 year 2021 Source: DOL Form 5500 series (EBSA) · plan year 2021 · EIN 82-1573223
2020	≈3	3 (3 active)	$12,680	$285,111	401(k)
active participants 3 admin name GUIDELINE, INC. ein 821573223 employees est 3 employer contrib usd 2151 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis active headcount suspect false is operating employer true last received 2021-06-18 naics 621399 naics rpe level 621399 naics rpe usd 152112.8 name ORIGIN HEALTH participant contrib usd 4464 payroll est usd 63771 plan assets usd 12680 plan count 1 revenue est headcount usd 456338 revenue est payroll usd 178132 revenue est usd 285111 signer name CAROL HO state FL total participants 3 year 2020 Source: DOL Form 5500 series (EBSA) · plan year 2020 · EIN 82-1573223
2019	≈2	2 (2 active)	$4,481	$186,301	401(k)
active participants 2 admin name GUIDELINE, INC. ein 821573223 employees est 2 employer contrib usd 1524 estimate method v1-uncalibrated-2026-08-17 final filings 0 first filings 0 has 401k true has pension plan true has welfare plan false headcount basis active headcount suspect false is operating employer true last received 2020-06-28 naics 621399 naics rpe level 621399 naics rpe usd 152112.8 name ORIGIN HEALTH participant contrib usd 2859 payroll est usd 40843 plan assets usd 4481 plan count 1 revenue est headcount usd 304226 revenue est payroll usd 114086 revenue est usd 186301 signer name CAROL HO state FL total participants 2 year 2019 Source: DOL Form 5500 series (EBSA) · plan year 2019 · EIN 82-1573223

Plan year

Employees (est.)

Participants

Plan assets

Revenue (est.)

401(k)

2024

≈8

11 (7 active)

—

$1.2M

401(k)

active participants

admin name

GUIDELINE RK, LLC

ein

821573223

employees est

employer contrib usd

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

active

headcount suspect

false

is operating employer

true

last received

2025-03-17

naics

621399

naics rpe level

621399

naics rpe usd

152112.8

name

ORIGIN HEALTH

participant contrib usd

plan assets usd

plan count

revenue est headcount usd

1216902

revenue est usd

1216902

signer name

QIAN LIU

state

total participants

year

2024

Source: DOL Form 5500 series (EBSA) · plan year 2024 · EIN 82-1573223

2023

≈8

7 (7 active)

$139,925

$1.4M

401(k)

active participants

admin name

GUIDELINE, INC.

ein

821573223

employees est

employer contrib usd

12898

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

active

headcount suspect

false

is operating employer

true

last received

2024-05-07

naics

621399

naics rpe level

621399

naics rpe usd

152112.8

name

ORIGIN HEALTH

participant contrib usd

40840

payroll est usd

583429

plan assets usd

139925

plan count

revenue est headcount usd

1216902

revenue est payroll usd

1629689

revenue est usd

1408251

signer name

QIAN LIU

state

total participants

year

2023

Source: DOL Form 5500 series (EBSA) · plan year 2023 · EIN 82-1573223

2022

≈3

4 (3 active)

$68,390

$728,459

401(k)

active participants

admin name

GUIDELINE, INC.

ein

821573223

employees est

employer contrib usd

8588

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

active

headcount suspect

false

is operating employer

true

last received

2023-05-26

naics

621399

naics rpe level

621399

naics rpe usd

152112.8

name

ORIGIN HEALTH

participant contrib usd

29141

payroll est usd

416300

plan assets usd

68390

plan count

revenue est headcount usd

456338

revenue est payroll usd

1162849

revenue est usd

728459

signer name

CHRISTINE RIMER

state

total participants

year

2022

Source: DOL Form 5500 series (EBSA) · plan year 2022 · EIN 82-1573223

2021

≈2

2 (2 active)

$39,894

$509,271

401(k)

active participants

admin name

GUIDELINE, INC.

ein

821573223

employees est

employer contrib usd

3419

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

active

headcount suspect

false

is operating employer

true

last received

2022-06-01

naics

621399

naics rpe level

621399

naics rpe usd

152112.8

name

ORIGIN HEALTH

participant contrib usd

21364

payroll est usd

305200

plan assets usd

39894

plan count

revenue est headcount usd

304226

revenue est payroll usd

852514

revenue est usd

509271

signer name

CHRISTINE RIMER

state

total participants

year

2021

Source: DOL Form 5500 series (EBSA) · plan year 2021 · EIN 82-1573223

2020

≈3

3 (3 active)

$12,680

$285,111

401(k)

active participants

admin name

GUIDELINE, INC.

ein

821573223

employees est

employer contrib usd

2151

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

active

headcount suspect

false

is operating employer

true

last received

2021-06-18

naics

621399

naics rpe level

621399

naics rpe usd

152112.8

name

ORIGIN HEALTH

participant contrib usd

4464

payroll est usd

63771

plan assets usd

12680

plan count

revenue est headcount usd

456338

revenue est payroll usd

178132

revenue est usd

285111

signer name

CAROL HO

state

total participants

year

2020

Source: DOL Form 5500 series (EBSA) · plan year 2020 · EIN 82-1573223

2019

≈2

2 (2 active)

$4,481

$186,301

401(k)

active participants

admin name

GUIDELINE, INC.

ein

821573223

employees est

employer contrib usd

1524

estimate method

v1-uncalibrated-2026-08-17

final filings

first filings

has 401k

true

has pension plan

true

has welfare plan

false

headcount basis

active

headcount suspect

false

is operating employer

true

last received

2020-06-28

naics

621399

naics rpe level

621399

naics rpe usd

152112.8

name

ORIGIN HEALTH

participant contrib usd

2859

payroll est usd

40843

plan assets usd

4481

plan count

revenue est headcount usd

304226

revenue est payroll usd

114086

revenue est usd

186301

signer name

CAROL HO

state

total participants

year

2019

Source: DOL Form 5500 series (EBSA) · plan year 2019 · EIN 82-1573223

Plan	Plan year	Participants	EIN
ORIGIN HEALTH 401(K) PLAN	—	—	—
ack id 20231009135300NAL0016916963001 admin ein — admin name — business code 621111 date received 2023-10-09 filing status FILING_RECEIVED filing year 2022 form type 5500_SF is 401k plan — pension benefit code 2A2E2F2G2J2K2T3D plan effective date 2022-01-01 plan name ORIGIN HEALTH 401(K) PLAN plan number 001 plan year begin date 2022-01-01 sponsor address1 2825 FORT MISSOULA RD, SUITE 304 sponsor address2 — sponsor city MISSOULA sponsor dba name — sponsor ein 843463861 sponsor name ORIGIN HEALTH, LLC sponsor phone 4067638833 sponsor state MT sponsor zip 59804 tax period 2022-12-31 total assets boy 0 total assets eoy 47312 total participants boy 15 welfare benefit code — Source: DOL form 5500 · document dol-5500/
ORIGIN HEALTH 401(K) PLAN	—	—	—
ack id 20240703123118NAL0004451027001 admin ein — admin name — business code 621111 date received 2024-07-03 filing status FILING_RECEIVED filing year 2023 form type 5500_SF is 401k plan — pension benefit code 2A2E2F2G2J2K2T3D plan effective date 2022-01-01 plan name ORIGIN HEALTH 401(K) PLAN plan number 001 plan year begin date 2023-01-01 sponsor address1 2825 FORT MISSOULA RD, SUITE 304 sponsor address2 — sponsor city MISSOULA sponsor dba name — sponsor ein 843463861 sponsor name ORIGIN HEALTH, LLC sponsor phone 4067638833 sponsor state MT sponsor zip 59804 tax period 2023-12-31 total assets boy 47312 total assets eoy 327320 total participants boy 21 welfare benefit code — Source: DOL form 5500 · document dol-5500/
ORIGIN HEALTH 401(K) PLAN	—	—	—
ack id 20250918163725NAL0003666450001 admin ein — admin name — business code 621111 date received 2025-09-18 filing status FILING_RECEIVED filing year 2024 form type 5500_SF is 401k plan — pension benefit code 2A2E2F2G2J2K2T3D plan effective date 2022-01-01 plan name ORIGIN HEALTH 401(K) PLAN plan number 001 plan year begin date 2024-01-01 sponsor address1 2825 FORT MISSOULA RD, SUITE 304 sponsor address2 — sponsor city MISSOULA sponsor dba name — sponsor ein 843463861 sponsor name ORIGIN HEALTH, LLC sponsor phone 4067638833 sponsor state MT sponsor zip 59804 tax period 2024-12-31 total assets boy 327320 total assets eoy 517695 total participants boy 29 welfare benefit code — Source: DOL form 5500 · document dol-5500/

Plan

Plan year

Participants

EIN

ORIGIN HEALTH 401(K) PLAN

—

ack id

20231009135300NAL0016916963001

admin ein

—

admin name

—

business code

621111

date received

2023-10-09

filing status

FILING_RECEIVED

filing year

2022

form type

5500_SF

is 401k plan

—

pension benefit code

2A2E2F2G2J2K2T3D

plan effective date

2022-01-01

plan name

ORIGIN HEALTH 401(K) PLAN

plan number

001

plan year begin date

2022-01-01

sponsor address1

2825 FORT MISSOULA RD, SUITE 304

sponsor address2

—

sponsor city

MISSOULA

sponsor dba name

—

sponsor ein

843463861

sponsor name

ORIGIN HEALTH, LLC

sponsor phone

4067638833

sponsor state

sponsor zip

59804

tax period

2022-12-31

total assets boy

total assets eoy

47312

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

ORIGIN HEALTH 401(K) PLAN

—

ack id

20240703123118NAL0004451027001

admin ein

—

admin name

—

business code

621111

date received

2024-07-03

filing status

FILING_RECEIVED

filing year

2023

form type

5500_SF

is 401k plan

—

pension benefit code

2A2E2F2G2J2K2T3D

plan effective date

2022-01-01

plan name

ORIGIN HEALTH 401(K) PLAN

plan number

001

plan year begin date

2023-01-01

sponsor address1

2825 FORT MISSOULA RD, SUITE 304

sponsor address2

—

sponsor city

MISSOULA

sponsor dba name

—

sponsor ein

843463861

sponsor name

ORIGIN HEALTH, LLC

sponsor phone

4067638833

sponsor state

sponsor zip

59804

tax period

2023-12-31

total assets boy

47312

total assets eoy

327320

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

ORIGIN HEALTH 401(K) PLAN

—

ack id

20250918163725NAL0003666450001

admin ein

—

admin name

—

business code

621111

date received

2025-09-18

filing status

FILING_RECEIVED

filing year

2024

form type

5500_SF

is 401k plan

—

pension benefit code

2A2E2F2G2J2K2T3D

plan effective date

2022-01-01

plan name

ORIGIN HEALTH 401(K) PLAN

plan number

001

plan year begin date

2024-01-01

sponsor address1

2825 FORT MISSOULA RD, SUITE 304

sponsor address2

—

sponsor city

MISSOULA

sponsor dba name

—

sponsor ein

843463861

sponsor name

ORIGIN HEALTH, LLC

sponsor phone

4067638833

sponsor state

sponsor zip

59804

tax period

2024-12-31

total assets boy

327320

total assets eoy

517695

total participants boy

welfare benefit code

—

Source: DOL form 5500 · document dol-5500/

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