| Name: | VILLAGE HOUSE CONVALESCENT HOME, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 06 Nov 1974 (50 years ago) |
| Identification Number: | 000014812 |
| ZIP code: | 02840 |
| County: | Newport County |
| Principal Address: | 70 HARRISON AVENUE, NEWPORT, RI, 02840, USA |
| Purpose: | OPERATING A SKILLED NURSING AND CONVALESCENT HOME |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Village House Nursing & Rehabilitation Center (trading name, 2009-08-28 - ) Village House (trading name, 1995-04-12 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033151519 | 2006-06-11 | 2024-11-08 | 70 HARRISON AVE, NEWPORT, RI, 028403879, US | 70 HARRISON AVE, NEWPORT, RI, 028403879, US | |||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-849-5222 |
| Fax | 4018495765 |
Authorized person
| Name | KELLY ARNOLD |
| Role | COO |
| Phone | 4017513800 |
Taxonomy
| Taxonomy Code | 313M00000X - Nursing Facility/Intermediate Care Facility |
| License Number | 589 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 589 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4105074 |
| State | RI |
| Issuer | BLUE CHIP |
| Number | 403199 |
| State | RI |
| Issuer | BLUE CROSS |
| Number | 50779 |
| State | RI |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 254900JLIME9G06FDW05 | 000014812 | US-RI | GENERAL | ACTIVE | 1974-11-06 | |||||||||||||||||||
|
||||||||||||||||||||||||
| Legal | c/o TERRY A. CARRAGHER, 359 BROAD STREET, PROVIDENCE, US-RI, US, 02907 |
| Headquarters | 70 HARRISON AVENUE, NEWPORT, US-RI, US, 02840 |
Registration details
| Registration Date | 2019-08-16 |
| Last Update | 2024-08-17 |
| Status | LAPSED |
| Next Renewal | 2024-08-16 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | 000014812 |
| Name | Role | Address |
|---|---|---|
| MICHAEL BIGNEY | Agent | 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860, USA |
| Name | Role | Address |
|---|---|---|
| DAVID M RYAN | PRESIDENT | 101 MELROSE AVE JMESTOWN, RI 02835 USA |
| Name | Role | Address |
|---|---|---|
| DAVID M RYAN | TREASURER | 101 MELROSE AVE JAMESTOWN, RI 02835 USA |
| Name | Role | Address |
|---|---|---|
| TERRY A CARRAGHER | SECRETARY | 232 BROADWAY PROVIDENCE, RI 02903 USA |
| Number | Name | File Date |
|---|---|---|
| 202460355890 | Statement of Change of Registered/Resident Agent | 2024-09-27 |
| 202452206120 | Annual Report | 2024-04-23 |
| 202336435820 | Annual Report | 2023-05-31 |
| 202208163820 | Annual Report | 2022-01-19 |
| 202185792390 | Annual Report | 2021-01-11 |
| 202033603270 | Annual Report | 2020-02-03 |
| 201989020430 | Annual Report | 2019-03-21 |
| 201855804160 | Annual Report | 2018-01-08 |
| 201734976720 | Annual Report | 2017-02-28 |
| 201690692230 | Annual Report | 2016-01-14 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
