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  5. Jewish Seniors Agency of Rhode Island

Jewish Seniors Agency of Rhode Island

Company Details

Name: Jewish Seniors Agency of Rhode Island
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Merged Into An Entity Of Record
Date of Organization in Rhode Island: 26 Feb 1930 (95 years ago)
Date of Dissolution: 24 Jun 2019 (6 years ago)
Date of Status Change: 24 Jun 2019 (6 years ago)
Identification Number: 000027136
ZIP code: 02904
County: Providence County
Principal Address: 1165 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA
Purpose: MINISTERING TO THE CONCERNS OF THE ELDERLY
NAICS: 624120 - Services for the Elderly and Persons with Disabilities
Fictitious names: Jewish Home for the Aged (trading name, 1999-06-21 - )
Jewish Home for the Aged of Rhode Island (trading name, 1999-06-21 - )
Jewish Home for the Aged of RI (trading name, 1999-06-21 - )
Historical names: Jewish Home for the Aged of Rhode Island

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1891869608 2006-11-20 2020-08-22 229 WATERMAN STREET, PROVIDENCE, RI, 02906, US 229 WATERMAN STREET, PROVIDENCE, RI, 02906, US

Contacts
Phone +1 401-351-4750
Fax 4014215905

Authorized person
Name PAUL R BARRETTE
Role EXECUTIVE DIRECTOR
Phone 4013514750

Taxonomy
Taxonomy Code 261QA0600X - Adult Day Care Clinic/Center
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number TC04772
State RI

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300XWC8L3NLQH5190 000027136 US-RI GENERAL ACTIVE No data

Addresses
Legal C/O Edward D. Feldstein, ESQ., 8th Floor, 10 Weybosset Street, Providence, US-RI, US, 02903
Headquarters C/O Edward D. Feldstein, ESQ., 8th Floor, 10 Weybosset Street, Providence, US-RI, US, 02903

Registration details
Registration Date 2013-04-08
Last Update 2023-08-04
Status LAPSED
Next Renewal 2014-04-08
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 000027136

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JEWISH SENIORS AGENCY RETIREMENT PLAN 2018 050258889 2019-07-27 JEWISH SENIORS AGENCY OF RHODE ISLAND 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750
JEWISH SENIORS AGENCY RETIREMENT PLAN 2018 050258889 2019-12-11 JEWISH SENIORS AGENCY OF RHODE ISLAND 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
JEWISH SENIORS AGENCY RETIREMENT PLAN 2017 050258889 2018-05-03 JEWISH SENIORS AGENCY OF RHODE ISLAND 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2018-05-03
Name of individual signing SUSAN BAZAR
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2016 050258889 2017-05-10 JEWISH SENIORS AGENCY OF RHODE ISLAND 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2017-05-10
Name of individual signing SUSAN BAZAR
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2015 050258889 2016-05-16 JEWISH SENIORS AGENCY OF RHODE ISLAND 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2016-05-16
Name of individual signing SUSAN BAZAR
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2014 050258889 2015-06-04 JEWISH SENIORS AGENCY OF RHODE ISLAND 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2015-06-04
Name of individual signing PAUL R. BARRETTE
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2013 050258889 2014-07-29 JEWISH SENIORS AGENCY OF RHODE ISLAND 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2014-07-29
Name of individual signing PAUL R. BARRETTE
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2012 050258889 2013-05-13 JEWISH SENIORS AGENCY OF RHODE ISLAND 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2013-05-13
Name of individual signing PAUL R. BARRETTE
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2011 050258889 2012-06-18 JEWISH SENIORS AGENCY OF RHODE ISLAND 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2012-06-18
Name of individual signing PAUL R. BARRETTE
Valid signature Filed with authorized/valid electronic signature
JEWISH SENIORS AGENCY RETIREMENT PLAN 2010 050258889 2011-06-01 JEWISH SENIORS AGENCY OF RHODE ISLAND 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2011-06-01
Name of individual signing PAUL R. BARRETTE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/14/20101014042826P070012190722001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 813000
Sponsor’s telephone number 4013514750
Plan sponsor’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907

Plan administrator’s name and address
Administrator’s EIN 050258889
Plan administrator’s name JEWISH SENIORS AGENCY OF RHODE ISLAND
Plan administrator’s address 100 NIANTIC AVENUE, PROVIDENCE, RI, 02907
Administrator’s telephone number 4013514750

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing CAROL LIPMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
EDWARD D. FELDSTEIN, ESQ. Agent 10 WEYBOSSET STREETSUITE 800, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
JEFFREY PADWA PRESIDENT 25 MARGRAVE AVENUE PROVIDENCE, RI 02906 USA

TREASURER

Name Role Address
DEBORAH MANDELL TREASURER 47 PRINCE STREET ATTLEBORO, MA 02703 USA

SECRETARY

Name Role Address
MINDY STONE SECRETARY 151 WOODBURY STREET PROVIDENCE, RI 02906 USA

DIRECTOR

Name Role Address
AVITAL CHATTO DIRECTOR 34 HART STREET PROVIDENCE, RI 02906 USA
ELAINE BUDISH DIRECTOR 363 ORMS STREET PROVIDENCE, RI 02908 USA
DOUGLAS EMANUEL DIRECTOR 101 MOUNT AVENUE PROVIDENCE, RI 02906 USA
STUART EINHORN DIRECTOR 45 EAMES STREET PROVIDENCE, RI 02906 USA

Events

Type Date Old Value New Value
Merged 2019-06-24 Jewish Seniors Agency of Rhode Island Jewish Collaborative Services on
Name Change 1999-06-21 Jewish Home for the Aged of Rhode Island Jewish Seniors Agency of Rhode Island

Filings

Number Name File Date
201997972620 Annual Report 2019-06-20
201872586180 Annual Report 2018-07-19
201746648370 Annual Report 2017-06-23
201629249490 Statement of Change of Registered/Resident Agent Office 2016-12-30
201629249120 Statement of Change of Registered/Resident Agent Office 2016-12-30
201601903620 Annual Report 2016-07-12
201563466630 Annual Report 2015-06-17
201441767600 Annual Report 2014-06-20
201323926930 Annual Report 2013-06-17
201294743950 Annual Report 2012-07-19

Related by officers

EDWARD D. FELDSTEIN, ESQ.

Airway Corporation AUTO FACTORY, INC. GRACE BARKER NURSING CENTER, INC. CAI Liquidation, Inc. MaJolie, Inc. Institute for Behavioral Medicine, Inc. TPH, Inc. SQUIRES SERVICES LTD. RENULCO REALTY CORP. International Etching, Inc.

JEFFREY PADWA

Jewish Family Service, Inc. Providence Police Community Foundation, Inc. PADWA LAW LLC Granoff, Inc. Solar Therapeutics Rhode Island, Inc.

DEBORAH MANDELL

Jewish Family Service, Inc.

MINDY STONE

Jewish Family Service, Inc. Shalom Housing, Inc. JHA HOUSING, INC. Shalom II Housing, Inc. Tamarisk, Inc. Jewish Collaborative Services

AVITAL CHATTO

Jewish Family Service, Inc. Community Libraries of Providence

ELAINE BUDISH

Jewish Family Service, Inc.

DOUGLAS EMANUEL

Jewish Community Center of Rhode Island Jewish Family Service, Inc.

STUART EINHORN

PB&J CORP.

Related by address

1165 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA

Friends of Jewish Seniors of Jewish Collaborative Services Shalom Housing, Inc. JHA HOUSING, INC. Shalom II Housing, Inc. Tamarisk, Inc. Breachway Property, LLC Jewish Seniors Assisted Living Support Corporation Apple Tree LLC Peach Tree Realty, Inc,

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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