| Name: | NEM, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 02 Feb 1970 (55 years ago) |
| Date of Dissolution: | 29 Dec 2011 (13 years ago) |
| Date of Status Change: | 29 Dec 2011 (13 years ago) |
| Identification Number: | 000008993 |
| ZIP code: | 02879 |
| County: | Washington County |
| Principal Address: | 981 KINGSTOWN ROAD, PEACE DALE, RI, 02879-3021, USA |
| Purpose: | NURSING HOME |
| Historical names: |
SCALLOP SHELL NURSING HOME, INC. SCALLOP SHELL NURSING & REHABILITATION CENTER, INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811999576 | 2005-08-12 | 2020-08-22 | 981 KINGSTOWN RD, PEACE DALE, RI, 028793042, US | 981 KINGSTOWN RD, PEACE DALE, RI, 028793042, US | |||||||||||||||||||||||||
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| Phone | +1 401-789-3006 |
| Fax | 4017893562 |
Authorized person
| Name | NEIL E. MAHONEY |
| Role | ADMINISTRATOR |
| Phone | 4017893006 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00352 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4105057 |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCALLOP SHELL NURSING & REHABILITATION CENTER INC PROFIT SHARING &401(K) | 2011 | 050343982 | 2012-09-26 | SCALLOP SHELL NURSING & REHABILITATION CENTER, INC | 89 | |||||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 050343982 |
| Plan administrator’s name | SCALLOP SHELL NURSING & REHABILITATION CENTER, INC |
| Plan administrator’s address | 981 KINGSTOWN ROAD, PEACE DALE, RI, 028799021 |
| Administrator’s telephone number | 4017893006 |
Signature of
| Role | Plan administrator |
| Date | 2012-09-26 |
| Name of individual signing | NEIL MAHONEY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-09-26 |
| Name of individual signing | NEIL MAHONEY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1980-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 4017893006 |
| Plan sponsor’s address | 981 KINGSTOWN ROAD, PEACE DALE, RI, 028799021 |
Plan administrator’s name and address
| Administrator’s EIN | 050343982 |
| Plan administrator’s name | SCALLOP SHELL NURSING & REHABILITATION CENTER, INC |
| Plan administrator’s address | 981 KINGSTOWN ROAD, PEACE DALE, RI, 028799021 |
| Administrator’s telephone number | 4017893006 |
Signature of
| Role | Plan administrator |
| Date | 2012-09-26 |
| Name of individual signing | NEIL MAHONEY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-09-26 |
| Name of individual signing | NEIL MAHONEY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| NEIL E. MAHONEY | Agent | 981 KINGSTOWN ROAD, PEACE DALE, RI, 02879-3021, USA |
| Name | Role | Address |
|---|---|---|
| NEIL E MAHONEY (DIRECTOR) | TREASURER | 981B KINGSTOWN ROAD PEACE DALE, RI 02879 USA |
| Name | Role | Address |
|---|---|---|
| EILEEN M. KOVACS (DIRECTOR) | SECRETARY | 25 OAK HILL ROAD PEACE DALE, RI 02879 USA |
| Name | Role | Address |
|---|---|---|
| NEIL E MAHONEY | PRESIDENT | 981B KINGSTOWN ROAD PEACE DALE, RI 02879- USA |
| Name | Role | Address |
|---|---|---|
| PAUL F MAHONEY (DIRECTOR) | VICE PRESIDENT | 200 PARK BLVD. N. APT 210 VENICE, FL 34285 USA |
| Name | Role | Address |
|---|---|---|
| WILLIAM D KOVACS | DIRECTOR | 25 OAK HILL ROAD PEACE DALE, RI 02879 USA |
| KATHLEEN A MAHONEY | DIRECTOR | 200 PARK BLVD. N. APT 210 VENICE, FL 34285 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2011-01-25 | SCALLOP SHELL NURSING & REHABILITATION CENTER, INC. | NEM, Inc. |
| Name Change | 2002-05-29 | SCALLOP SHELL NURSING HOME, INC. | SCALLOP SHELL NURSING & REHABILITATION CENTER, INC. |
| Number | Name | File Date |
|---|---|---|
| 201187389140 | Articles of Dissolution | 2011-12-29 |
| 201176257100 | Annual Report | 2011-03-07 |
| 201173994350 | Articles of Amendment | 2011-01-25 |
| 201058575920 | Annual Report | 2010-02-18 |
| 200839709550 | Annual Report | 2008-12-24 |
| 200805415760 | Annual Report | 2008-01-09 |
Date of last update: 05 Oct 2024
Sources: Rhode Island Department of State
