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  5. Westerly Nursing Home, Inc.

Westerly Nursing Home, Inc.

Company Details

Name: Westerly Nursing Home, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Dissolved
Date of Organization in Rhode Island: 26 Feb 1964 (61 years ago)
Date of Dissolution: 29 Apr 2020 (5 years ago)
Date of Status Change: 29 Apr 2020 (5 years ago)
Identification Number: 000017329
ZIP code: 02891
County: Washington County
Principal Address: 79 BEACH STREET, WESTERLY, RI, 02891, USA
Purpose: TO OPERATE A NURSING HOME
NAICS: 623110 - Nursing Care Facilities (Skilled Nursing Facilities)
Historical names: WATCH HILL NURSING HOME, INC.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669464699 2005-08-16 2013-06-11 79 BEACH ST, WESTERLY, RI, 028912717, US 79 BEACH ST, WESTERLY, RI, 028912717, US

Contacts
Phone +1 401-596-4925
Fax 4015962967

Authorized person
Name MR. PAUL V. MARTIN
Role ADMINISTRATOR
Phone 4015964925

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 492
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2016 050312266 2017-07-21 WESTERLY NURSING HOME, INC. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2015 050312266 2016-04-15 WESTERLY NURSING HOME, INC. 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2014 050312266 2015-05-22 WESTERLY NURSING HOME, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2013 050312266 2014-05-28 WESTERLY NURSING HOME, INC. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2014-05-28
Name of individual signing PAUL V. MARTIN
Valid signature Filed with authorized/valid electronic signature
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2012 050312266 2014-05-28 WESTERLY NURSING HOME, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2014-05-28
Name of individual signing PAUL V. MARTIN
Valid signature Filed with authorized/valid electronic signature
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2012 050312266 2013-05-22 WESTERLY NURSING HOME, INC. 84
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2013-05-22
Name of individual signing PAUL V. MARTIN
Valid signature Filed with authorized/valid electronic signature
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2011 050312266 2012-06-26 WESTERLY NURSING HOME, INC. 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050312266
Plan administrator’s name WESTERLY NURSING HOME, INC.
Plan administrator’s address 79 BEACH STREET, WESTERLY, RI, 02891
Administrator’s telephone number 4015964925

Signature of
Role Plan administrator
Date 2012-06-26
Name of individual signing PAUL V. MARTIN
Valid signature Filed with authorized/valid electronic signature
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEE PROFIT SHARING PLAN 2010 050312266 2011-06-22 WESTERLY NURSING HOME, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050312266
Plan administrator’s name WESTERLY NURSING HOME, INC.
Plan administrator’s address 79 BEACH STREET, WESTERLY, RI, 02891
Administrator’s telephone number 4015964925

Signature of
Role Plan administrator
Date 2011-06-22
Name of individual signing PAUL V. MARTIN
Valid signature Filed with authorized/valid electronic signature
WESTERLY NURSING HOME, INC. 401(K) EMPLOYEES PROFIT SHARING PLAN 2009 050312266 2010-09-21 WESTERLY NURSING HOME, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-03-01
Business code 623000
Sponsor’s telephone number 4015964925
Plan sponsor’s address 79 BEACH STREET, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050312266
Plan administrator’s name WESTERLY NURSING HOME, INC.
Plan administrator’s address 79 BEACH STREET, WESTERLY, RI, 02891
Administrator’s telephone number 4015964925

Signature of
Role Plan administrator
Date 2010-09-21
Name of individual signing PAUL V. MARTIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HASLAW, INC. Agent 100 WESTMINSTER STREET SUITE 1500 C/O HINCKLEY ALLEN & SNYDER LLP, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
M. SHEILA MARTIN MD PRESIDENT 1434 N. WHISPERWOOD DRIVE FERNANDO, FL 34442 USA

TREASURER

Name Role Address
PAUL V. MARTIN TREASURER 153 WATCH HILL ROAD WESTERLY, RI 02891 USA

SECRETARY

Name Role Address
PAUL V. MARTIN SECRETARY 153 WATCH HILL ROAD WESTERLY, RI 02891 USA

VICE PRESIDENT

Name Role Address
SHAWN M. MARTIN VICE PRESIDENT 25 BABCOCK ROAD WESTERLY, RI 02891 USA

DIRECTOR

Name Role Address
PAUL V. MARTIN DIRECTOR 153 WATCH HILL ROAD WESTERLY, RI 02891 USA
MARK A. MARTIN DIRECTOR 125 TIMBERLAKE DRIVE INMAN, SC 29349 USA
COLLEEN M. DENEEN DIRECTOR 113 BOUNDRY COURT GRASS VALLEY, CA 95945 USA
PATRICK J. MARTIN DIRECTOR 9107 LINKS DRIVE FORT MEYERS, FL 33913 USA
SHAWN M. MARTIN DIRECTOR 25 BABCOCK ROAD WESTERLY, RI 02891 USA
M. SHEILA MARTIN MD DIRECTOR 1434 N. WHISPERWOOD DRIVE FERNANDO, FL 34442 USA
JAMES F. MARTIN, JR. DIRECTOR 43 WICKLOW ROAD WESTERLY, RI 02891 USA
PETER A. MARTIN DIRECTOR 351 E. BELLEVUE SAN MATEO, CA 94401 USA

Events

Type Date Old Value New Value
Name Change 1965-01-14 WATCH HILL NURSING HOME, INC. Westerly Nursing Home, Inc.

Filings

Number Name File Date
202038833320 Articles of Dissolution 2020-04-29
202038794270 Annual Report 2020-04-28
201986630380 Annual Report 2019-02-14
201861124610 Annual Report 2018-03-28
201740992640 Annual Report 2017-04-14
201696067320 Annual Report - Amended 2016-04-19
201695405600 Annual Report 2016-03-30
201695405420 Statement of Change of Registered/Resident Agent Office 2016-03-30
201558164660 Annual Report 2015-03-29
201440684340 Statement of Change of Registered/Resident Agent 2014-06-06

Related by officers

HASLAW, INC.

Atwood Pediatrics, Inc. CEDAR HILLS REALTY, INC. Little Feet Disc Jockey, Inc. Coe-Hosford Agency, Inc. CORP BROTHERS, INCORPORATED CRA-MAR CORPORATION CRANSTON BUILDERS, INC. M. F. CONSTRUCTION CORP. MANUEL FERREIRA, INC. Daniele International, Inc.

M. SHEILA MARTIN MD

CEDAR HILLS REALTY, INC.

PAUL V. MARTIN

CEDAR HILLS REALTY, INC.

SHAWN M. MARTIN

CEDAR HILLS REALTY, INC.

Related by address

79 BEACH STREET, WESTERLY, RI, 02891, USA

CEDAR HILLS REALTY, INC.

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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