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Tockwotton Home

Company Details

Name: Tockwotton Home
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 02 Jan 1857 (168 years ago)
Identification Number: 000030138
ZIP code: 02914
County: Providence County
Principal Address: 500 WATERFRONT DRIVE, EAST PROVIDENCE, RI, 02914, USA
Purpose: ENACTED BY THE GENERAL ASSEMBLY DURING THE JANUARY SESSION OF 1857. RESIDENCE WHERE OLDER WOMEN AND MEN MAY LIVE SECURELY IN COMFORT AND DIGNITY. JANUARY SESSION 1857
NAICS: 623110 - Nursing Care Facilities (Skilled Nursing Facilities)
Fictitious names: Tockwotton on the Waterfront (trading name, 2012-11-07 - )
Historical names: HOME FOR AGED WOMEN

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1366561631 2007-03-28 2015-04-16 500 WATERFRONT DRIVE, EAST PROVIDENCE, RI, 029145047, US 500 WATERFRONT DRIVE, EAST PROVIDENCE, RI, 029145047, US

Contacts

Phone +1 401-272-5280
Fax 4014210550

Authorized person

Name MR. KEVIN MCKAY
Role EXECUTIVE DIRECTOR
Phone 4012725280

Taxonomy

Taxonomy Code 310400000X - Assisted Living Facility
License Number ALR01360
State RI
Is Primary Yes
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 4105113
State RI
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 4105113
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TOCKWOTTON HOME RETIREMENT SAVINGS PLAN 2010 050258881 2011-07-13 TOCKWOTTON HOME 107
Three-digit plan number (PN) 002
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 4012725280
Plan sponsor’s address 75 EAST STREET, PROVIDENCE, RI, 029034472

Plan administrator’s name and address

Administrator’s EIN 050258881
Plan administrator’s name TOCKWOTTON HOME
Plan administrator’s address 75 EAST STREET, PROVIDENCE, RI, 029034472
Administrator’s telephone number 4012725280
TOCKWOTTON HOME RETIREMENT SAVINGS PLAN 2010 050258881 2011-07-19 TOCKWOTTON HOME 107
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 4012725280
Plan sponsor’s address 75 EAST STREET, PROVIDENCE, RI, 029034472

Plan administrator’s name and address

Administrator’s EIN 050258881
Plan administrator’s name TOCKWOTTON HOME
Plan administrator’s address 75 EAST STREET, PROVIDENCE, RI, 029034472
Administrator’s telephone number 4012725280

Signature of

Role Plan administrator
Date 2011-07-19
Name of individual signing ROBERT E MARTIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-19
Name of individual signing TOCKWOTTON HOME
Valid signature Filed with authorized/valid electronic signature
TOCKWOTTON HOME RETIREMENT SAVINGS PLAN 2010 050258881 2011-07-13 TOCKWOTTON HOME 107
Three-digit plan number (PN) 002
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 4012725280
Plan sponsor’s address 75 EAST STREET, PROVIDENCE, RI, 029034472

Plan administrator’s name and address

Administrator’s EIN 050258881
Plan administrator’s name TOCKWOTTON HOME
Plan administrator’s address 75 EAST STREET, PROVIDENCE, RI, 029034472
Administrator’s telephone number 4012725280
TOCKWOTTON HOME RETIREMENT SAVINGS PLAN 2009 050258881 2010-08-03 TOCKWOTTON HOME 100
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 4012725280
Plan sponsor’s address 75 EAST ST, PROVIDENCE, RI, 029034472

Plan administrator’s name and address

Administrator’s EIN 050258881
Plan administrator’s name TOCKWOTTON HOME
Plan administrator’s address 75 EAST ST, PROVIDENCE, RI, 029034472
Administrator’s telephone number 4012725280

Signature of

Role Plan administrator
Date 2010-07-12
Name of individual signing ROBERT E. MARTIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-12
Name of individual signing TOCKWOTTON
Valid signature Filed with authorized/valid electronic signature
TOCKWOTTON HOME RETIREMENT SAVINGS PLAN 2009 050258881 2010-07-12 TOCKWOTTON HOME 100
Three-digit plan number (PN) 002
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 4012725280
Plan sponsor’s address 75 EAST ST, PROVIDENCE, RI, 029034472

Plan administrator’s name and address

Administrator’s EIN 050258881
Plan administrator’s name TOCKWOTTON HOME
Plan administrator’s address 75 EAST ST, PROVIDENCE, RI, 029034472
Administrator’s telephone number 4012725280

Signature of

Role Plan administrator
Date 2010-07-12
Name of individual signing ROBERT E. MARTIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-12
Name of individual signing TOCKWOTTON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JOYCE M. NALLEN Agent 500 WATERFRONT DRIVE, EAST PROVIDENCE, RI, 02914, USA

PRESIDENT

Name Role Address
KEVIN MCKAY PRESIDENT 500 WATERFRONT DRIVE EAST PROVIDENCE, RI 02914 USA

DIRECTOR

Name Role Address
KRISTEN BRETON DIRECTOR 21 KIRKBRAE DRIVE LINCOLN, RI 02865 USA

Events

Type Date Old Value New Value
Name Change 1977-11-01 HOME FOR AGED WOMEN Tockwotton Home

Filings

Number Name File Date
202454649240 Annual Report 2024-05-16
202339480250 Annual Report 2023-07-14
202338443670 Revocation Notice For Failure to File An Annual Report 2023-06-20
202217755320 Annual Report 2022-05-23
202198557650 Annual Report 2021-06-22
202044516620 Annual Report 2020-07-10
201998336980 Annual Report 2019-06-21
201870631350 Annual Report 2018-06-25
201746727660 Annual Report 2017-06-26
201600987810 Annual Report 2016-06-23

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State