| Name: | LIFE CARE CENTERS OF AMERICA, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 23 Apr 1986 (39 years ago) |
| Identification Number: | 000038368 |
| Place of Formation: | TENNESSEE |
| Principal Address: | 3570 KEITH STREET NW, CLEVELAND, TN, 37312, USA |
| Purpose: | SKILLED NURSING FACILITY OWNER / MANAGER / OPERATOR |
| Fictitious names: |
Evergreen House Health Center (trading name, 2012-11-13 - ) Cherry Hill Manor (trading name, 2012-10-24 - ) |
NAICS
623110 Nursing Care Facilities (Skilled Nursing Facilities)This industry comprises establishments primarily engaged in providing inpatient nursing and rehabilitative services. The care is generally provided for an extended period of time to individuals requiring nursing care. These establishments have a permanent core staff of registered or licensed practical nurses who, along with other staff, provide nursing and continuous personal care services. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275596108 | 2006-04-11 | 2021-09-15 | 3001 KEITH ST NW, CLEVELAND, TN, 373123713, US | 2 CHERRY HILL RD, JOHNSTON, RI, 029192687, US | |||||||||||||||||||||||||||||
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| Phone | +1 423-473-5751 |
| Fax | 4233398342 |
| Phone | +1 401-231-3102 |
| Fax | 4012325520 |
Authorized person
| Name | CINDY CROSS |
| Role | ASSISTANT SECRETARY |
| Phone | 4234735867 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00699 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 699 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN ZIEGLER | TREASURER | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| Name | Role | Address |
|---|---|---|
| LISA M. LAY | SECRETARY | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| Name | Role | Address |
|---|---|---|
| FORREST L. PRESTON | CEO | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| Name | Role | Address |
|---|---|---|
| JOAN E. THURMOND | ASSISTANT SECRETARY | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| CINDY S CROSS | ASSISTANT SECRETARY | 3570 KEITH STREET NW CLEVELAND, TN 37312 USA |
| Name | Role | Address |
|---|---|---|
| TERRY HENRY | ASSISTANT TREASURER | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| Name | Role | Address |
|---|---|---|
| RICHARD SWANKER | CHIEF TAX OFFICER | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| Name | Role | Address |
|---|---|---|
| TODD FLETCHER | PRESIDENT | 3570 KEITH STREET, NW CLEVELAND, TN 37312 USA |
| Number | Name | File Date |
|---|---|---|
| 202445181850 | Annual Report | 2024-02-01 |
| 202329739180 | Annual Report | 2023-03-01 |
| 202209689310 | Annual Report | 2022-02-08 |
| 202193615490 | Annual Report | 2021-03-05 |
| 202033996020 | Annual Report | 2020-02-10 |
| 201915755300 | Annual Report | 2019-08-27 |
| 201906968810 | Revocation Notice For Failure to File An Annual Report | 2019-07-24 |
| 201859106260 | Annual Report | 2018-02-26 |
| 201737856920 | Annual Report | 2017-03-10 |
| 201694678690 | Annual Report | 2016-03-14 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 341644987 | 0112300 | 2015-04-10 | 1 EVERGREEN HOUSE HEALTH CENTER, EAST PROVIDENCE, RI, 02914 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 312338445 | 0112300 | 2008-09-11 | 1 EVERGREEN DRIVE, EAST PROVIDENCE, RI, 02914 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19100212 A01 |
| Issuance Date | 2008-12-17 |
| Abatement Due Date | 2008-12-26 |
| Current Penalty | 637.5 |
| Initial Penalty | 1275.0 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| Gravity | 01 |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19100303 G01 IA |
| Issuance Date | 2008-12-17 |
| Abatement Due Date | 2008-12-26 |
| Current Penalty | 637.5 |
| Initial Penalty | 1275.0 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 01 |
| Citation ID | 01003A |
| Citaton Type | Serious |
| Standard Cited | 19101030 C01 IIA |
| Issuance Date | 2008-12-17 |
| Abatement Due Date | 2008-12-25 |
| Current Penalty | 637.5 |
| Initial Penalty | 1275.0 |
| Nr Instances | 1 |
| Nr Exposed | 175 |
| Gravity | 01 |
| Citation ID | 01003B |
| Citaton Type | Serious |
| Standard Cited | 19101030 C01 IIB |
| Issuance Date | 2008-12-17 |
| Abatement Due Date | 2008-12-26 |
| Nr Instances | 1 |
| Nr Exposed | 175 |
| Gravity | 01 |
| Citation ID | 01003C |
| Citaton Type | Serious |
| Standard Cited | 19101030 C01 IIC |
| Issuance Date | 2008-12-17 |
| Abatement Due Date | 2008-12-26 |
| Nr Instances | 1 |
| Nr Exposed | 175 |
| Gravity | 01 |
Date of last update: 07 Apr 2025
Sources: Rhode Island Department of State
