| Name: | Elmhurst Extended Care Facilities, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 01 Oct 1985 (39 years ago) |
| Date of Dissolution: | 18 Feb 2015 (10 years ago) |
| Date of Status Change: | 18 Feb 2015 (10 years ago) |
| Identification Number: | 000036042 |
| ZIP code: | 02908 |
| County: | Providence County |
| Principal Address: | 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908, USA |
| Purpose: | LONG TERM AND SUB-ACUTE PATIENT CARE. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164467221 | 2006-06-20 | 2007-11-27 | 50 MAUDE ST, PROVIDENCE, RI, 029084325, US | 50 MAUDE ST, PROVIDENCE, RI, 029084325, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-456-2623 |
| Fax | 4014566862 |
Authorized person
| Name | MR. RICHARD E. GAMACHE |
| Role | VP/ADMINSTRATOR |
| Phone | 4014562623 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00663 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4105084 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| RICHARD GAMACHE | Agent | 50 MAUDE STREET, PROVIDENCE, RI, 02908, USA |
| Name | Role | Address |
|---|---|---|
| KENNETH H BELCHER | PRESIDENT | 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA |
| Name | Role | Address |
|---|---|---|
| DONALD C. MCQUEEN | DIRECTOR | 3 SHADY LANE BARRINGTON, RI 02806 USA |
| Number | Name | File Date |
|---|---|---|
| 201555190130 | Revocation Certificate For Failure to File the Annual Report for the Year | 2015-02-18 |
| 201449706980 | Revocation Notice For Failure to File An Annual Report | 2014-11-06 |
| 201324925860 | Annual Report | 2013-06-24 |
| 201294309110 | Annual Report | 2012-06-26 |
| 201180858580 | Annual Report | 2011-06-30 |
| 201063586180 | Annual Report | 2010-06-16 |
| 201055788620 | Articles of Amendment | 2010-01-04 |
| 200947992310 | Annual Report | 2009-07-03 |
| 200812072620 | Annual Report | 2008-06-19 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
