| Name: | Saint Elizabeth Home, East Greenwich |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 15 Mar 1883 (142 years ago) |
| Identification Number: | 000029363 |
| ZIP code: | 02818 |
| County: | Kent County |
| Principal Address: | ONE SAINT ELIZABETH WAY, EAST GREENWICH, RI, 02818, USA |
| Purpose: | ENACTED BY THE GENERAL ASSEMBLY DURING THE JANUARY SESSION OF 1883 EFFECTIVE 3/15/1883. OPERATING A NURSING HOME JANUARY SESSION 1883 |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Saint Elizabeth GREEN HOUSE® Homes (trading name, 2021-07-29 - ) |
| Historical names: |
Saint Elizabeth Home |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053428185 | 2006-08-24 | 2008-01-16 | ONE SAINT ELIZABETH WAY, EAST GREENWICH, RI, 02818, US | ONE SAINT ELIZABETH WAY, EAST GREENWICH, RI, 02818, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-471-6060 |
| Fax | 4014716072 |
Authorized person
| Name | MR. STEVEN J HOROWITZ |
| Role | CEO/PRESIDENT |
| Phone | 4014716060 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00728 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | EVERCARE |
| Number | 7101027 |
| State | RI |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 405122 |
| State | RI |
| Issuer | MEDICAID |
| Number | 4105010 |
| State | RI |
| Issuer | UNITED HEALTHCARE |
| Number | 7100078 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| SANDRA MATRONE MACK | Agent | 10 WEYBOSSET STREET SUITE 905, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| MATTHEW TRIMBLE | CEO | 2364 POST RD STE 100 WARWICK, RI 02886 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN W. TILLEY | CHAIR | 602 EAST SHORE RD JAMESTOWN, RI 02835 USA |
| Name | Role | Address |
|---|---|---|
| CLAIRE C. FLAHERTY | VICE CHAIR | 936 BUTTONWOODS AVENUE WARWICK, RI 02886 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN H. KITCHIN | TREASURER | ONE NEW ENGLAND TECH BLVD EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| JUDY VIGAR | SECRETARY | 7 LARCH AVENUE NARRAGANSETT, RI 02882 USA |
| Name | Role | Address |
|---|---|---|
| KIMBERLEY RANALLI | DIRECTOR | 100 SOCKANOSSET CROSSROAD, RDC170 CRANSTON, RI 02920 USA |
| TIMOTHY MURRAY | DIRECTOR | 221 BROADWAY PROVIDENCE, RI 02903 USA |
| PETER HOLLMAN, MD | DIRECTOR | 74 FORT AVE. CRANSTON, RI 02905 USA |
| CRAIG W. CARPENTER | DIRECTOR | 29 SOUTH POND DRIVE COVENTRY, RI 02816 USA |
| FREDERICK G. HARRISON | DIRECTOR | 19 CHANNEL VW., UNIT 2 WARWICK, RI 02889 USA |
| KRISTEN L. DISANTO | DIRECTOR | 23 BROAD STREET WESTERLY, RI 02891 USA |
| ROBIN DZIUBA | DIRECTOR | ONE CITIZENS PLAZA, SUITE 1000 PROVIDENCE, RI 02903 USA |
| MARK J. PROVOST | DIRECTOR | PO BOX 444 EAST GREENWICH, RI 02818 USA |
| E. PAUL LARRAT, PH.D. R.PH. | DIRECTOR | 853 GILBERT STUART RD. SAUNDERSTOWN, RI 02874 USA |
| SCOTT SEABACK | DIRECTOR | 56 MAPLE STREET WARWICK, RI 02886 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2003-03-07 | Saint Elizabeth Home | Saint Elizabeth Home, East Greenwich |
| Number | Name | File Date |
|---|---|---|
| 202447562710 | Annual Report - Amended | 2024-02-29 |
| 202447386910 | Annual Report | 2024-02-27 |
| 202335936580 | Statement of Change of Registered/Resident Agent | 2023-05-22 |
| 202334898230 | Annual Report | 2023-05-01 |
| 202215503860 | Annual Report | 2022-04-22 |
| 202199610930 | Fictitious Business Name Statement | 2021-07-29 |
| 202198860750 | Annual Report | 2021-06-30 |
| 202042140160 | Annual Report | 2020-06-12 |
| 201903392410 | Annual Report | 2019-07-11 |
| 201872594590 | Annual Report | 2018-07-19 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
