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  5. Blackstone Health, Inc.

Blackstone Health, Inc.

Company Details

Name: Blackstone Health, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 08 Jan 1987 (38 years ago)
Identification Number: 000041462
ZIP code: 02886
County: Kent County
Principal Address: 51 HEALTH LANE, WARWICK, RI, 02886, USA
Purpose: TO PROVIDE COMMUNITY BASED HEALTH SERVICES THAT ARE RESPONSIVE TO THE NEEDS AND DEMOGRAPHIC MAKEUP OF THE BLACKSTONE VALLEY COMMUNITY AND OTHER COMMUNITIES.
Fictitious names: New Horizons Adult Day Center (trading name, 2013-11-04 - )
Comprehensive Older Adult Services (trading name, 1997-10-08 - )
C.O.A.S.I. (trading name, 1997-10-08 - )
Historical names: Health Promotion Center Corp.
Comprehensive Older Adult Services, Inc.

Industry & Business Activity

NAICS

813920 Professional Organizations

This industry comprises establishments primarily engaged in promoting the professional interests of their members and the profession as a whole. These establishments may conduct research; develop statistics; sponsor quality and certification standards; lobby public officials; or publish newsletters, books, or periodicals for distribution to their members. Learn more at the U.S. Census Bureau

Companies doing Professional organizations

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467583534 2007-03-08 2020-08-22 426 MAIN ST, PAWTUCKET, RI, 028602912, US 426 MAIN ST, PAWTUCKET, RI, 028602912, US

Contacts
Phone +1 401-727-0950
Fax 4017253053

Authorized person
Name MR. THOMAS GOUGH
Role EXECUTIVE DIRECTOR
Phone 4017270950

Taxonomy
Taxonomy Code 261QA0600X - Adult Day Care Clinic/Center
License Number 13
State RI
Is Primary Yes

Other Provider Identifiers
Issuer STATE LICENSE
Number 13
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLACKSTONE HEALTH, INC. 401(K) PLAN 2014 050427007 2015-11-05 BLACKSTONE HEALTH, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-12-31
Sponsor’s telephone number 4017292147
Plan sponsor’s address 420 MAIN STREET, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2015-11-05
Name of individual signing NANCY ROBERTS
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE HEALTH, INC. 401(K) PLAN 2014 050427007 2015-09-01 BLACKSTONE HEALTH, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-12-31
Sponsor’s telephone number 4017292147
Plan sponsor’s address 420 MAIN STREET, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2015-09-01
Name of individual signing NANCY ROBERTS
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE HEALTH, INC. 401(K) PLAN 2013 050427007 2014-09-02 BLACKSTONE HEALTH, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-12-31
Sponsor’s telephone number 4017292147
Plan sponsor’s address 420 MAIN STREET, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2014-09-02
Name of individual signing NANCY ROBERTS
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE HEALTH, INC. DBA COASI TAX SHELTERED ANNUITY PLAN 2012 050427007 2013-12-10 BLACKSTONE HEALTH, INC. 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-12-31
Business code 813000
Sponsor’s telephone number 4017256444
Plan sponsor’s address 420 MAIN STREET, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2013-12-10
Name of individual signing NANCY ROBERTS
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE HEALTH, INC. DBA COASI TAX SHELTERED ANNUITY PLAN 2012 050427007 2013-06-11 BLACKSTONE HEALTH, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-12-31
Business code 813000
Sponsor’s telephone number 4017292147
Plan sponsor’s address 420 MAIN STREET, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2013-06-11
Name of individual signing THOMAS GOUGH
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE HEALTH, INC. PENSION PLAN 2012 050427007 2013-06-07 BLACKSTONE HEALTH, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-12-31
Sponsor’s telephone number 4017292147
Plan sponsor’s address 420 MAIN STREET, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2013-06-07
Name of individual signing THOMAS GOUGH
Valid signature Filed with authorized/valid electronic signature

CHAIR

Name Role Address
KARL SHERRY CHAIR HAYES & SHERRY, 146 WESTMINSTER ST., 2ND FLR. PROVIDENCE, RI 02903 USA

EX OFFICIO DIRECTOR

Name Role Address
MICHAEL WAGNER MD EX OFFICIO DIRECTOR 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA
JANE PIKE-BENTON EX OFFICIO DIRECTOR 51 HEALTH LANE WARWICK, RI 02886 USA

DIRECTOR

Name Role Address
F. PAUL MOONEY, JR. DIRECTOR 39 DROWNE PARKWAY RUMFORD, RI 02916 USA

Agent

Name Role Address
JANE PIKE-BENTON Agent 51 HEALTH LANE, WARWICK, RI, 02886, USA

TREASURER

Name Role Address
LOUIS CHABOT TREASURER 455 TOLL GATE ROAD WARWICK, RI 02886 USA

SECRETARY

Name Role Address
JAMES A. BRIDEN ESQ SECRETARY 144 BANK STREET ATTLEBORO, RI 02703 USA

PRESIDENT

Name Role Address
JANE PIKE-BENTON PRESIDENT 51 HEALTH LANE WARWICK, RI 02886 USA

Events

Type Date Old Value New Value
Name Change 1997-10-08 Comprehensive Older Adult Services, Inc. Blackstone Health, Inc.
Name Change 1997-07-22 Health Promotion Center Corp. Comprehensive Older Adult Services, Inc.
Merged 1997-07-22 Comprehensive Older Adult Services, Inc. on Blackstone Health, Inc.

Filings

Number Name File Date
202453341190 Annual Report 2024-04-30
202334855620 Annual Report 2023-05-01
202215775320 Annual Report 2022-04-26
202198173300 Annual Report 2021-06-11
202192126410 Annual Report 2021-02-19
202191783380 Revocation Notice For Failure to File An Annual Report 2021-02-17
201996739530 Annual Report 2019-06-14
201872355470 Articles of Amendment 2018-07-13
201869261650 Annual Report 2018-06-11
201742841720 Annual Report 2017-05-05

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
05-0427007 Corporation Unconditional Exemption 420 MAIN ST, PAWTUCKET, RI, 02860-2912 1999-03
In Care of Name % KATHY TOPOR
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Literary Organization, Social Welfare Organization, Labor Organization, Chamber of Commerce, Mutual Cooperative Telephone Co.
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-09
Asset 1,000,000 to 4,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 1581350
Income Amount 1700264
Form 990 Revenue Amount 1700264
National Taxonomy of Exempt Entities Unknown: Unknown
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name BLACKSTONE HEALTH INC
EIN 05-0427007
Tax Period 202209
Filing Type E
Return Type 990
File View File
Organization Name BLACKSTONE HEALTH INC
EIN 05-0427007
Tax Period 202109
Filing Type E
Return Type 990
File View File
Organization Name BLACKSTONE HEALTH INC
EIN 05-0427007
Tax Period 201909
Filing Type E
Return Type 990
File View File
Organization Name BLACKSTONE HEALTH INC
EIN 05-0427007
Tax Period 201809
Filing Type E
Return Type 990
File View File
Organization Name BLACKSTONE HEALTH INC
EIN 05-0427007
Tax Period 201709
Filing Type E
Return Type 990
File View File
Organization Name BLACKSTONE HEALTH INC
EIN 05-0427007
Tax Period 201609
Filing Type E
Return Type 990
File View File

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Related by address

51 HEALTH LANE, WARWICK, RI, 02886, USA

KENT COUNTY VISITING NURSE ASSOCIATION HealthTouch, Inc. VNA of Care New England Foundation

Date of last update: 07 Apr 2025

Sources: Rhode Island Department of State

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