| Name: | WOODLAND CONVALESCENT CENTER, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 16 May 1972 (53 years ago) |
| Date of Dissolution: | 09 Nov 2010 (14 years ago) |
| Date of Status Change: | 09 Nov 2010 (14 years ago) |
| Identification Number: | 000018677 |
| ZIP code: | 02896 |
| County: | Providence County |
| Principal Address: | 70 WOODLAND ROAD, NORTH SMITHFIELD, RI, 02896, USA |
| Purpose: | NURSING HOME |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003897828 | 2005-11-09 | 2020-08-22 | 70 WOODLAND RD, NORTH SMITHFIELD, RI, 028968204, US | 70 WOODLAND RD, NORTH SMITHFIELD, RI, 028968204, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-765-0499 |
| Fax | 4017651225 |
Authorized person
| Name | MARY-ANN ABBRUZZI |
| Role | PRESIDENT/ADMINISTRATOR |
| Phone | 4017650499 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00580 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4105103 |
| State | RI |
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 50742 |
| State | RI |
| Issuer | BLUECHIP HEALTH PLAN |
| Number | 412727 |
| State | RI |
| Issuer | NSC |
| Number | 0550090001 |
| Name | Role | Address |
|---|---|---|
| SYDNEY I. RESNICK, ESQ. | Agent | 1005 RESERVOIR AVENUE, CRANSTON, RI, 02910, USA |
| Name | Role | Address |
|---|---|---|
| MARY ANN ABBRUZZI | PRESIDENT | OLD LOUISQUISSET ROAD, POLE 64 LINCOLN, RI 02865 USA |
| Number | Name | File Date |
|---|---|---|
| 201071990580 | Revocation Certificate For Failure to File the Annual Report for the Year | 2010-11-09 |
| 201063045470 | Revocation Notice For Failure to File An Annual Report | 2010-06-16 |
| 200943075260 | Annual Report | 2009-02-24 |
| 200805789500 | Annual Report | 2008-01-15 |
Date of last update: 06 Apr 2025
Sources: Rhode Island Department of State
