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  5. JOHN CLARKE RETIREMENT CENTER

JOHN CLARKE RETIREMENT CENTER

Company Details

Name: JOHN CLARKE RETIREMENT CENTER
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 12 Mar 1979 (46 years ago)
Identification Number: 000029448
ZIP code: 02842
County: Newport County
Principal Address: 600 VALLEY ROAD, MIDDLETOWN, RI, 02842, USA
Purpose: LONG TERM NURSING CARE
NAICS: 624120 - Services for the Elderly and Persons with Disabilities
Fictitious names: John Clarke Senior Living (trading name, 2021-05-14 - )
Historical names: THE JOHN CLARKE RETIREMENT CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1144338476 2006-08-27 2023-06-01 600 VALLEY RD, MIDDLETOWN, RI, 028427014, US 600 VALLEY RD, MIDDLETOWN, RI, 028427014, US

Contacts
Phone +1 401-846-0743
Fax 4018485890

Authorized person
Name JOAN M. WOODS
Role CHIEF EXECUTIVE OFFICER
Phone 4013245424

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number LTC00634
State RI
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 4105076
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2023 050382511 2024-03-21 THE JOHN CLARKE RETIREMENT CENTER 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2022 050382511 2023-04-05 THE JOHN CLARKE RETIREMENT CENTER 98
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2021 050382511 2022-03-01 THE JOHN CLARKE RETIREMENT CENTER 95
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2020 050382511 2021-05-11 THE JOHN CLARKE RETIREMENT CENTER 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2019 050382511 2020-07-29 THE JOHN CLARKE RETIREMENT CENTER 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 028427014

Signature of
Role Plan administrator
Date 2020-07-29
Name of individual signing JOAN WOODS
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2018 050382511 2019-07-18 THE JOHN CLARKE RETIREMENT CENTER 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 028427014

Signature of
Role Plan administrator
Date 2019-07-18
Name of individual signing KRISTEN TAVARES
Valid signature Filed with authorized/valid electronic signature
403 B THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2017 050382511 2018-08-31 THE JOHN CLARKE RETIREMENT CENTER 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 028427014

Signature of
Role Plan administrator
Date 2018-08-31
Name of individual signing JOE SOUSA
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2016 050382511 2017-04-07 THE JOHN CLARKE RETIREMENT CENTER 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2017-04-07
Name of individual signing JOE SOUSA
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2015 050382511 2016-07-14 THE JOHN CLARKE RETIREMENT CENTER 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing JOE SOUSA
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2014 050382511 2016-07-13 THE JOHN CLARKE RETIREMENT CENTER 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/13/20160713090423P040031430167001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/12/20160712100028P030024351469001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/12/20160712111129P030030503095001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/12/20160712100040P030024352061001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLET RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/07/20101007111235P070014501249001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Plan administrator’s name and address
Administrator’s EIN 050382511
Plan administrator’s name THE JOHN CLARKE RETIREMENT CENTER
Plan administrator’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842
Administrator’s telephone number 4018460743

Signature of
Role Plan administrator
Date 2010-10-07
Name of individual signing NANCY E. CICOGNA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-07
Name of individual signing NANCY E. CICOGNA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHERI L. PIZZI Agent ONE FINANCIAL PLAZA 18TH FLOOR C/O BARTON GILMAN LLP, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
JOHN THORPE PRESIDENT 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

TREASURER

Name Role Address
HUGH HALL TREASURER 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

SECRETARY

Name Role Address
DAVID MAINE SECRETARY 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

VICE PRESIDENT

Name Role Address
KAREN PIACENTINI VICE PRESIDENT 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

DIRECTOR

Name Role Address
JOSEPH MARION DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
JENNIFER FAIRBANK DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
RACHEL CARPENTER DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
PETER CHATELLIER DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
JOHN SWEENEY DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
CHRISTINE MCGUIRE DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
JOHN BAGWILL DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

Events

Type Date Old Value New Value
Name Change 2021-05-14 THE JOHN CLARKE RETIREMENT CENTER JOHN CLARKE RETIREMENT CENTER

Filings

Number Name File Date
202445323980 Annual Report 2024-02-02
202326418060 Annual Report 2023-01-23
202211286550 Annual Report 2022-02-17
202196603700 Fictitious Business Name Statement 2021-05-14
202196603340 Articles of Amendment 2021-05-14
202196562890 Annual Report 2021-05-12
202042311740 Annual Report 2020-06-16
202040705280 Statement of Change of Registered/Resident Agent 2020-05-22
202032576340 Statement of Change of Registered/Resident Agent 2020-01-17
201927687200 Annual Report 2019-11-19

Related by officers

SHERI L. PIZZI

Barton Gilman LLP Barton Gilman LLP BARTON GILMAN LLP BARTON GILMAN LLP BARTON GILMAN LLP

HUGH HALL

Healthcentric Advisors, Inc. OCEAN STATE POST ACUTE NETWORK, LLC PINNACLE HOME CARE, LLC

JOSEPH MARION

Acme Boiler Rentals, Inc. Atlas Boiler Works, Inc. C.D.S. REALTY,INC. FORT ADAMS TRUST, INC. Data Storage Corporation

PETER CHATELLIER

FRANK B. STRUZIK, INC. SIVASET REALTY, INC.

JOHN SWEENEY

Plaza Coin-Op, Inc. Club Twenty-One JS Consultants, LLC New Erie Scientific LLC Richard-Allan Scientific LLC

CHRISTINE MCGUIRE

St. George's School

JOHN BAGWILL

Easton's Point Association, Inc.

Related by address

No related companies by address

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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