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  5. GRACE BARKER NURSING CENTER, INC.

GRACE BARKER NURSING CENTER, INC.

Company Details

Name: GRACE BARKER NURSING CENTER, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 14 Nov 1966 (58 years ago)
Identification Number: 000001961
ZIP code: 02885
County: Bristol County
Principal Address: 54 BARKER AVENUE, WARREN, RI, 02885, USA
Purpose: OPERATE A NURSING HOME BUSINESS
NAICS: 623110 - Nursing Care Facilities (Skilled Nursing Facilities)
Fictitious names: Grace Barker Health (trading name, 2017-04-24 - )
The Cove at Grace Barker (trading name, 2017-04-24 - )
Historical names: GRACE BARKER NURSING HOME, INC.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1164462818 2006-06-08 2022-04-12 54 BARKER AVE, WARREN, RI, 028852025, US 54 BARKER AVE, WARREN, RI, 028852025, US

Contacts
Phone +1 401-245-9100
Fax 4012453730

Authorized person
Name MR. BENJAMIN ELIAS LESCAULT
Role ADMINISTRATION
Phone 4012459100

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 692
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GRACE BARKER NURSING HOME INC. 401(K) PROFIT SHARING PLAN 2023 050313873 2024-05-29 GRACE BARKER NURSING HOME INC. 98
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2024-05-29
Name of individual signing BENJAMIN LESCAULT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-29
Name of individual signing BENJAMIN LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2022 050313873 2023-06-30 GRACE BARKER NURSING HOME, INC. 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2023-06-30
Name of individual signing MARY SYLVIA
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2021 050313873 2022-10-07 GRACE BARKER NURSING HOME, INC. 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2022-10-07
Name of individual signing MARY SYLVIA
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2020 050313873 2021-10-05 GRACE BARKER NURSING HOME, INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2019 050313873 2020-06-24 GRACE BARKER NURSING HOME, INC. 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2020-06-24
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2018 050313873 2019-10-03 GRACE BARKER NURSING HOME, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2019-10-03
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2017 050313873 2018-06-07 GRACE BARKER NURSING HOME, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2018-06-07
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2016 050313873 2017-04-27 GRACE BARKER NURSING HOME, INC. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2017-04-27
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2015 050313873 2016-10-03 GRACE BARKER NURSING HOME, INC. 105
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
GRACE BARKER NURSING HOME INC 401(K) PROFIT SHARING PLAN 2014 050313873 2015-07-23 GRACE BARKER NURSING HOME, INC. 105
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/12/20140612133222P030382896083001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2014-06-12
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/23/20130923141132P030001084197001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Signature of
Role Plan administrator
Date 2013-09-23
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/21/20120621110747P040005731956001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Plan administrator’s name and address
Administrator’s EIN 050313873
Plan administrator’s name GRACE BARKER NURSING HOME, INC.
Plan administrator’s address 54 BARKER AVENUE, WARREN, RI, 02885
Administrator’s telephone number 4012459100

Signature of
Role Plan administrator
Date 2012-06-21
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/15/20110915102923P040019950626001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Plan administrator’s name and address
Administrator’s EIN 050313873
Plan administrator’s name GRACE BARKER NURSING HOME, INC.
Plan administrator’s address 54 BARKER AVENUE, WARREN, RI, 02885
Administrator’s telephone number 4012459100

Signature of
Role Plan administrator
Date 2011-09-15
Name of individual signing MARK LESCAULT
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 BARKER AVENUE, WARREN, RI, 02885

Plan administrator’s name and address
Administrator’s EIN 050313873
Plan administrator’s name GRACE BARKER NURSING HOME, INC.
Plan administrator’s address 54 BARKER AVENUE, WARREN, RI, 02885
Administrator’s telephone number 4012459100

Signature of
Role Plan administrator
Date 2011-06-17
Name of individual signing ADP RETIREMENT SERVICES COMPLIANCE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/06/08/20100608114534P040074115944001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-05-01
Business code 623000
Sponsor’s telephone number 4012459100
Plan sponsor’s address 54 GRACE BARKER AVE, WARREN, RI, 02885

Plan administrator’s name and address
Administrator’s EIN 050313873
Plan administrator’s name GRACE BARKER NURSING HOME INC
Plan administrator’s address 54 GRACE BARKER AVE, WARREN, RI, 02885
Administrator’s telephone number 4012459100

Signature of
Role Plan administrator
Date 2010-06-08
Name of individual signing GRACE BARKER NURSING HOME INC
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
EDWARD D. FELDSTEIN, ESQ. Agent 10 WEYBOSSET STREET SUITE 800, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
MARY BETH LESCAULT PRESIDENT 54 BARKER AVENUE WARREN, RI 02885 USA

SECRETARY

Name Role Address
MARY BETH LESCAULT SECRETARY 54 BARKER AVENUE WARREN, RI 02885 USA

VICE PRESIDENT

Name Role Address
MARK LESCAULT VICE PRESIDENT 54 BARKER AVENUE WARREN, RI 02885 USA

TREASURER

Name Role Address
BENJAMIN LESCAULT TREASURER 54 BARKER AVENUE WARREN, RI 02885 USA

Events

Type Date Old Value New Value
Name Change 1995-01-01 GRACE BARKER NURSING HOME, INC. GRACE BARKER NURSING CENTER, INC.

Filings

Number Name File Date
202447823280 Annual Report 2024-03-05
202330947950 Annual Report 2023-03-16
202212216150 Annual Report 2022-03-04
202185942010 Annual Report 2021-01-12
202031329820 Annual Report 2020-01-08
201985143520 Annual Report 2019-01-25
201856776600 Annual Report 2018-01-25
201741648690 Fictitious Business Name Statement 2017-04-24
201741648870 Fictitious Business Name Statement 2017-04-24
201731069740 Annual Report 2017-01-30

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
307577577 0112300 2006-05-18 54 BARKER AVENUE, WARREN, RI, 02885
Inspection Type Planned
Scope Complete
Safety/Health Health
Close Conference 2006-05-26
Emphasis N: NURSING, L: EISA, N: SSTARG05
Case Closed 2006-06-15

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 19100151 C
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Current Penalty 550.0
Initial Penalty 1100.0
Nr Instances 1
Nr Exposed 3
Gravity 02
Citation ID 01002A
Citaton Type Serious
Standard Cited 19101030 C01 V
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Current Penalty 550.0
Initial Penalty 1100.0
Nr Instances 1
Gravity 02
Citation ID 01002B
Citaton Type Serious
Standard Cited 19101030 H05 I
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Nr Instances 1
Nr Exposed 2
Gravity 02
Citation ID 01003
Citaton Type Serious
Standard Cited 19101030 D04 IIIA4
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Current Penalty 962.5
Initial Penalty 1925.0
Nr Instances 1
Nr Exposed 2
Gravity 05
Citation ID 02001
Citaton Type Other
Standard Cited 19040029 B06
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Nr Instances 1
Nr Exposed 2
Gravity 00
Citation ID 02002
Citaton Type Other
Standard Cited 19101030 F01 IID
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Nr Instances 1
Nr Exposed 2
Gravity 01
Citation ID 02003
Citaton Type Other
Standard Cited 19101030 F05
Issuance Date 2006-05-31
Abatement Due Date 2006-07-18
Nr Instances 1
Nr Exposed 2
Gravity 01
307572792 0112300 2005-06-09 54 BARKER AVENUE, WARREN, RI, 02885
Inspection Type Prog Other
Scope Partial
Safety/Health Safety
Close Conference 2005-08-25
Case Closed 2005-08-25

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4700187110 2020-04-13 0165 PPP 54 Barker Avenue, WARREN, RI, 02885-2000
Loan Status Date 2021-08-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 943710
Loan Approval Amount (current) 943710
Undisbursed Amount 0
Franchise Name -
Lender Location ID 32784
Servicing Lender Name BayCoast Bank
Servicing Lender Address 330 Swansea Mall Dr, SWANSEA, MA, 02777-4112
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WARREN, BRISTOL, RI, 02885-2000
Project Congressional District RI-01
Number of Employees 146
NAICS code 623110
Borrower Race White
Borrower Ethnicity Hispanic or Latino
Business Type Subchapter S Corporation
Originating Lender ID 32784
Originating Lender Name BayCoast Bank
Originating Lender Address SWANSEA, MA
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 954038.38
Forgiveness Paid Date 2021-05-20

Related by officers

EDWARD D. FELDSTEIN, ESQ.

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MARK LESCAULT

The Willows, an Assisted Living and Adult Day Care Community Incorporated

BENJAMIN LESCAULT

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Related by address

54 BARKER AVENUE, WARREN, RI, 02885, USA

BENETHAN, LLC Lescault Family, LLC

Date of last update: 05 Oct 2024

Sources: Rhode Island Department of State

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