| Name: | NANCY ANN NURSING HOME, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 19 Jun 1973 (52 years ago) |
| Date of Dissolution: | 02 Aug 2018 (7 years ago) |
| Date of Status Change: | 02 Aug 2018 (7 years ago) |
| Identification Number: | 000013751 |
| ZIP code: | 02825 |
| County: | Providence County |
| Principal Address: | 47 EAST KILLINGLY ROAD, FOSTER, RI, 02825, USA |
| Purpose: | 20 BED NURSING HOME |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Historical names: |
NANCY ANN NURSING HOME, INC.INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811949068 | 2006-05-16 | 2020-08-22 | 47 E KILLINGLY RD, FOSTER, RI, 028251429, US | 47 E KILLINGLY RD, FOSTER, RI, 028251429, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-647-2170 |
| Fax | 4016479020 |
Authorized person
| Name | ROBERT E. FOSS JR. |
| Role | OWNER/ADMINISTRATOR |
| Phone | 4016472170 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 410-5115 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4105115 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| ROBERT E. FOSS JR. | Agent | 47 EAST KILLINGLY ROAD, FOSTER, RI, 02825, USA |
| Name | Role | Address |
|---|---|---|
| ROBERT EDWARD FOSS JR | PRESIDENT | 47 EAST KILLINGLY ROAD FOSTER, RI 02825 USA |
| Name | Role | Address |
|---|---|---|
| ROBERT EDWARD FOSS JR | SECRETARY | 47 EAST KILLINGLY ROAD FOSTER, RI 02825 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1991-02-06 | NANCY ANN NURSING HOME, INC.INC. | NANCY ANN NURSING HOME, INC. |
| Number | Name | File Date |
|---|---|---|
| 201873735370 | Articles of Dissolution | 2018-08-02 |
| 201856339030 | Annual Report | 2018-01-18 |
| 201729591570 | Annual Report | 2017-01-06 |
| 201690100960 | Annual Report | 2016-01-06 |
| 201552976980 | Annual Report | 2015-01-08 |
| 201435452190 | Annual Report | 2014-02-12 |
| 201306911010 | Annual Report | 2013-01-04 |
| 201289147620 | Annual Report | 2012-02-07 |
| 201174024920 | Annual Report | 2011-01-26 |
| 201057969450 | Annual Report | 2010-02-04 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
