| Name: | Crestwood Nursing & Rehabilitation Center, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 12 Sep 1978 (47 years ago) |
| Identification Number: | 000005231 |
| ZIP code: | 02885 |
| County: | Bristol County |
| Principal Address: | 568 CHILD STREET, WARREN, RI, 02885, USA |
| Purpose: | OPERATION AND CONDUCT OF A GENERAL NURSING CARE AND CONVALESCENT FACILITY |
| Historical names: |
CRESTWOOD NURSING AND CONVALESCENT HOME, INC. |
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
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205822517 | 2005-09-22 | 2015-10-19 | 568 CHILD ST, WARREN, RI, 028851734, US | 568 CHILD ST, WARREN, RI, 028851734, US | |||||||||||||||||||||||||
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| Phone | +1 401-245-1574 |
| Fax | 4012470211 |
Authorized person
| Name | MR. GARY M MINASSIAN |
| Role | ADMINISTRATOR |
| Phone | 4012451574 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 628 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 628 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CHACE RUTTENBERG & FREEDMAN, LLP | Agent | ONE PARK ROW SUITE 300, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| GARY M MINASSIAN | PRESIDENT | P. O. BOX 308 WARREN, RI 02885 USA |
| Name | Role | Address |
|---|---|---|
| GAIL V MINASSIAN | TREASURER | P. O. BOX 308 WARREN, RI 02885 USA |
| Name | Role | Address |
|---|---|---|
| GREGORY J MINASSIAN | SECRETARY | P. O. BOX 308 WARREN, RI 02885 USA |
| Name | Role | Address |
|---|---|---|
| GREGORY J MINASSIAN | VICE PRESIDENT | P. O. BOX 308 WARREN, RI 02885 USA |
| Name | Role | Address |
|---|---|---|
| GARY M MINASSIAN | DIRECTOR | P. O. BOX 308 WARREN, RI 02885 USA |
| GREGORY J MINASSIAN | DIRECTOR | P. O. BOX 308 WARREN, RI 02885 USA |
| GAIL V MINASSIAN | DIRECTOR | P. O. BOX 308 WARREN, RI 02885 USA |
| MARK MINASSIAN | DIRECTOR | P. O. BOX 308 WARREN , RI 02885 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2016-01-08 | CRESTWOOD NURSING AND CONVALESCENT HOME, INC. | Crestwood Nursing & Rehabilitation Center, Inc. |
| Number | Name | File Date |
|---|---|---|
| 202452994180 | Annual Report | 2024-04-29 |
| 202328347160 | Annual Report | 2023-02-14 |
| 202209718650 | Annual Report | 2022-02-08 |
| 202191905890 | Annual Report | 2021-02-18 |
| 202038148910 | Statement of Change of Registered/Resident Agent | 2020-04-21 |
| 202033099370 | Annual Report | 2020-01-27 |
| 201985345140 | Annual Report | 2019-01-29 |
| 201857584970 | Annual Report | 2018-02-05 |
| 201734665480 | Annual Report | 2017-02-24 |
| 201691109890 | Annual Report | 2016-01-22 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3335128607 | 2021-03-16 | 0165 | PPP | 568 Child St, Warren, RI, 02885-1734 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 05 Apr 2025
Sources: Rhode Island Department of State
