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Avalon Nursing Home, Inc.

Company Details

Name: Avalon Nursing Home, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 17 Mar 1964 (61 years ago)
Identification Number: 000001677
ZIP code: 02889
County: Kent County
Purpose: AN INSTITUTION FOR THE BOARD AND CARE AND TREATMENT OF AGED, SICK AND CONVALESENT PEOPLE
Principal Address: Google Maps Logo 57 STOKES STREET, WARWICK, RI, 02889-3425, USA

Contact Details

Phone +1 401-738-1200

Industry & Business Activity

NAICS

623110 Nursing Care Facilities (Skilled Nursing Facilities)

This industry comprises establishments primarily engaged in providing inpatient nursing and rehabilitative services. The care is generally provided for an extended period of time to individuals requiring nursing care. These establishments have a permanent core staff of registered or licensed practical nurses who, along with other staff, provide nursing and continuous personal care services. Learn more at the U.S. Census Bureau

Agent

Name Role Address
LISA J. KOWALIK Agent 57 STOKES STREET, WARWICK, RI, 02889, USA

PRESIDENT

Name Role Address
DAVID KOWALIK PRESIDENT 54 ORMSBY AVE WARWICK, RI 02886 USA

National Provider Identifier

NPI Number:
1891776522
Certification Date:
2020-01-21

Authorized Person:

Name:
MR. DAVID STEPHEN KOWALIK
Role:
ASSISTANT ADMINISTRATOR
Phone:

Taxonomy:

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

Contacts:

Fax:
4017389430

Form 5500 Series

Employer Identification Number (EIN):
050305151
Plan Year:
2023
Number Of Participants:
37
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
37
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
41
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
39
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
40
Sponsors Telephone Number:

Licenses

License No License Type Status Date Issued Expiration Date
FSV01795 Seats - Less than 50 Active 1992-06-09 2026-04-30
LTC00446 Nursing Facility Active 1909-10-18 2025-12-31

Filings

Number Name File Date
202455384870 Annual Report 2024-06-06
202339780800 Annual Report 2023-07-26
202337976160 Revocation Notice For Failure to File An Annual Report 2023-06-19
202214419270 Annual Report 2022-04-11
202193430390 Annual Report 2021-03-02

Uniform Commercial Code

The Uniform Commercial Code (UCC) is a comprehensive set of laws governing all commercial transactions in the United States.

A UCC filing is a public notice of a secured transaction. A financing statement indicates a commercial agreement between a debtor and a secured party.

Uniform Commercial Code Summary

Type:
UCC-1 Standard
UCC Filing Number:
Filing Date:
2022-05-11
Action:
InitialFiling

Parties

Party Name:
Avalon Nursing Home, Inc.
Party Role:
Debtor(s)
Party Name:
Party Role:
Secured Parties

Inspections

Inspection Type Performed By Inspection Date Inspection Purpose
Food Establishment Inspection Rhode Island Department of Health, Center for Food Protection 2025-05-13 Routine
Food Establishment Inspection Rhode Island Department of Health, Center for Food Protection 2024-05-14 Routine
Food Establishment Inspection Rhode Island Department of Health, Center for Food Protection 2023-05-08 Re-Inspection
Food Establishment Inspection Rhode Island Department of Health, Center for Food Protection 2023-04-25 Routine
Food Establishment Inspection Rhode Island Department of Health, Center for Food Protection 2022-05-09 Re-Inspection

Expenditures

Agency Date Program Subprogram Amount
Department of Administration 2024-07-12 CENTRAL MANAGEMENT DIRECTOR'S OFFICE 50855.0
Department of Administration 2022-12-23 CENTRAL MANAGEMENT DIRECTOR'S OFFICE 132380.37

USAspending Awards / Financial Assistance

Date:
2020-05-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
303990.00
Total Face Value Of Loan:
303990.00

Paycheck Protection Program

Date Approved:
2020-05-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
303990
Current Approval Amount:
303990
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
307329.73

Date of last update: 16 May 2025

Sources: Rhode Island Department of State