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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.
NAICS: 813920 - Professional Organizations
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.

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

Agent

Name Role Address
KATHLEEN PEIRCE Agent 51 HEALTH LANE, WARWICK, RI, 02886, USA

TREASURER

Name Role Address
KATHLEEN TOPOR TREASURER VNA OF CARE NEW ENGLAND, 51 HEALTH LANE WARWICK, RI 02886 USA

SECRETARY

Name Role Address
JAMES BRIDEN, ESQ. SECRETARY P.O. BOX 1325, 150 MAIN STREET PAWTUCKET, RI 02862 USA

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
JENNIFER LEE 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

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

Related by officers

KATHLEEN PEIRCE

RHODE ISLAND VISITING NURSE NETWORK, INC. KENT COUNTY VISITING NURSE ASSOCIATION HealthTouch, Inc.

KATHLEEN TOPOR

VNA of Care New England Foundation

JAMES BRIDEN, ESQ.

NSJ, LLC 160 North Bend Street, LLC

KARL SHERRY

IN-SIGHT Wannamoisett Country Club Grand Island, LLC

MICHAEL WAGNER MD

HOSPITAL ASSOCIATION OF RHODE ISLAND HOSPITAL RESEARCH AND EDUCATION FOUNDATION OF RHODE ISLAND KENT COUNTY VISITING NURSE ASSOCIATION Grandview Realty Corporation The Memorial Hospital The Providence Center, Inc. STANDARD REALTY, INC. Women & Infants Hospital of Rhode Island Kent County Memorial Hospital Butler Hospital

JENNIFER LEE

KENT COUNTY VISITING NURSE ASSOCIATION Little Compton Village Improvement Society VNA of Care New England Foundation Common Root Botanicals LLC

F. PAUL MOONEY, JR.

FREDERICK C. TANNER MEMORIAL FUND, INC. The Discovery Mint, Inc.

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: 06 Oct 2024

Sources: Rhode Island Department of State

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