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  5. Scalabrini Villa, Inc.

Scalabrini Villa, Inc.

Headquarter

Company Details

Name: Scalabrini Villa, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 18 Aug 1989 (36 years ago)
Identification Number: 000057111
ZIP code: 02852
County: Washington County
Principal Address: 860 NORTH QUIDNESSETT RD, NORTH KINGSTOWN, RI, 02852, USA
Purpose: TO MAINTAIN A NURSING HOME

Industry & Business Activity

NAICS

622110 General Medical and Surgical Hospitals

This industry comprises establishments known and licensed as general medical and surgical hospitals primarily engaged in providing diagnostic and medical treatment (both surgical and nonsurgical) to inpatients with any of a wide variety of medical conditions. These establishments maintain inpatient beds and provide patients with food services that meet their nutritional requirements. These hospitals have an organized staff of physicians and other medical staff to provide patient care services. These establishments usually provide other services, such as outpatient services, anatomical pathology services, diagnostic X-ray services, clinical laboratory services, operating room services for a variety of procedures, and pharmacy services. Learn more at the U.S. Census Bureau

Companies doing General medical and surgical hospitals

Links between entities

Type Company Name Company Number State
Headquarter of Scalabrini Villa, Inc., ILLINOIS CORP_55994811 ILLINOIS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437157898 2005-07-11 2007-08-03 860 N QUIDNESSETT RD, NORTH KINGSTOWN, RI, 028521000, US 860 N QUIDNESSETT RD, NORTH KINGSTOWN, RI, 028521000, US

Contacts
Phone +1 401-884-1802
Fax 4018844727

Authorized person
Name JOY RYAN
Role ADMINISTRATOR
Phone 4018841802

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number LTC00367
State RI
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS & BLUE SHIELD
Number 5003
State RI
Issuer MEDICAID
Number 4105063
State RI
Issuer UNITED HEALTHCARE OF NE
Number 71-07104
State RI
Issuer BLUE CHIP OF RI
Number 40-2433
State RI
Issuer UNITED HEALTH - EVERCARE
Number 71-01149
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SCALABRINI VILLA 401K PLAN 2021 050449292 2022-03-17 SCALABRINI VILLA, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2020 050449292 2021-04-07 SCALABRINI VILLA, INC. 88
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2019 050449292 2020-05-19 SCALABRINI VILLA, INC. 106
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2018 050449292 2019-04-23 SCALABRINI VILLA, INC. 88
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2017 050449292 2018-04-25 SCALABRINI VILLA, INC. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2016 050449292 2017-07-05 SCALABRINI VILLA, INC. 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2015 050449292 2016-06-13 SCALABRINI VILLA, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
SCALABRINI VILLA 401K PLAN 2014 050449292 2015-08-26 SCALABRINI VILLA 88
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852

Plan administrator’s name and address
Administrator’s EIN 050449292
Plan administrator’s name SCALABRINI VILLA
Plan administrator’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Administrator’s telephone number 4018841802

Signature of
Role Plan administrator
Date 2015-08-26
Name of individual signing JOY RYAN
Valid signature Filed with authorized/valid electronic signature
SCALABRINI VILLA 401K PLAN 2013 050449292 2014-04-02 SCALABRINI VILLA 101
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852

Plan administrator’s name and address
Administrator’s EIN 050449292
Plan administrator’s name SCALABRINI VILLA
Plan administrator’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Administrator’s telephone number 4018841802

Signature of
Role Plan administrator
Date 2014-04-02
Name of individual signing JOY RYAN
Valid signature Filed with authorized/valid electronic signature
SCALABRINI VILLA 401K PLAN 2012 050449292 2013-07-09 SCALABRINI VILLA 102
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852

Plan administrator’s name and address
Administrator’s EIN 050449292
Plan administrator’s name SCALABRINI VILLA
Plan administrator’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Administrator’s telephone number 4018841802

Signature of
Role Plan administrator
Date 2013-07-09
Name of individual signing JOY RYAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/07/20120607195031P030002861222001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852

Plan administrator’s name and address
Administrator’s EIN 050449292
Plan administrator’s name SCALABRINI VILLA
Plan administrator’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Administrator’s telephone number 4018841802

Signature of
Role Plan administrator
Date 2012-06-07
Name of individual signing JOY RYAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/06/08/20110608075616P040002248947001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852

Plan administrator’s name and address
Administrator’s EIN 050449292
Plan administrator’s name SCALABRINI VILLA
Plan administrator’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Administrator’s telephone number 4018841802

Signature of
Role Plan administrator
Date 2011-06-08
Name of individual signing JOY RYAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/06/22/20100622202618P040032566419001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 623000
Sponsor’s telephone number 4018841802
Plan sponsor’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852

Plan administrator’s name and address
Administrator’s EIN 050449292
Plan administrator’s name SCALABRINI VILLA
Plan administrator’s address 86 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Administrator’s telephone number 4018841802

Signature of
Role Plan administrator
Date 2010-06-22
Name of individual signing JOY RYAN
Valid signature Filed with authorized/valid electronic signature

PRESIDENT

Name Role Address
REV. HORECIO CARLOS ANKLAN CS PRESIDENT 27 CARMINE STREET NEW YORK, NY 10014 USA

TREASURER

Name Role Address
REV. SERGIO DALLAGNESE CS TREASURER 27 CARMINE STREET NEW YORK, NY 10014 USA

SECRETARY

Name Role Address
REV. JEFFERSON ORLANDO BARIVIERA CS SECRETARY 27 CARMINE STREET NEW YORK, NY 10014 USA

VICE PRESIDENT

Name Role Address
REV. RUBENS SYLVAIN CS VICE PRESIDENT 27 CARMINE STREET NEW YORK, NY 10014 USA

DIRECTOR

Name Role Address
REV. SERGIO DALLAGNESE CS DIRECTOR 27 CARMINE STREET NEW YORK, NY 10014 USA
REV. MAURIZIO MAIFREDI CS DIRECTOR 27 CARMINE STREET NEW YORK, NY 10014 USA
REV. HORECIO CARLOS ANKLAN CS DIRECTOR 27 CARMINE STREET NEW YORK, NY 10014 USA
REV. RUBENS SYLVAIN CS DIRECTOR 27 CARMINE STREET NEW YORK, NY 10014 USA
REV. JEFFERSON ORLANDO BARIVIERA CS DIRECTOR 27 CARMINE STREET NEW YORK, NY 10014 USA

Agent

Name Role Address
FELIMON RODRIGUEZ SIXTOS Agent 297 LAUREL HILL AVENUE, PROVIDENCE, RI, 02909, USA

Filings

Number Name File Date
202452374810 Annual Report 2024-04-24
202339424290 Annual Report 2023-07-12
202339414020 Statement of Change of Registered/Resident Agent 2023-07-12
202338426970 Revocation Notice For Failure to File An Annual Report 2023-06-20
202211334990 Statement of Change of Registered/Resident Agent 2022-02-22
202209306280 Annual Report 2022-02-03
202199504130 Annual Report - Amended 2021-07-23
202198803270 Annual Report 2021-06-29
202045986440 Annual Report 2020-07-22
201998312560 Annual Report 2019-06-21

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
344880935 0112300 2020-08-14 860 NORTH QUIDNESSETT RD., NORTH KINGSTOWN, RI, 02852
Inspection Type Fat/Cat
Scope Partial
Safety/Health Health
Close Conference 2020-08-14
Case Closed 2021-04-08

Related Activity
Type Accident
Activity Nr 1643328
Type Inspection
Activity Nr 1504216
Health Yes
Type Inspection
Activity Nr 1510905
Health Yes

Violation Items
Citation ID 01001A
Citaton Type Serious
Standard Cited 19100134 C01
Issuance Date 2020-12-23
Abatement Due Date 2021-01-27
Current Penalty 9446.0
Initial Penalty 9446.0
Final Order 2021-01-21
Nr Instances 1
Nr Exposed 68
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.134(c)(1): A written respiratory protection program that included the provisions in 29 CFR 1910.134(c)(1)(i) - (ix) with worksite-specific procedures was not established and implemented for required respirator use: a) Scalabrini Villa Skilled Nursing & Rehabilitation Center located at 860 North Quidnessett Rd., North Kingstown, RI: On or about 6/24/2020, the employer did not develop and implement a written respiratory protection program with worksite-specific procedures for respirator use that included all provisions in 29 CFR 1910.134(c)(1)(i) - (ix), such as but not limited to medical evaluations. The employer required employees to wear respirators throughout their shifts while exposed to suspected, or confirmed, positive COVID-19 residents.
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100134 E01
Issuance Date 2020-12-23
Abatement Due Date 2021-01-27
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2021-01-21
Nr Instances 1
Nr Exposed 68
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.134(e)(1):The employer did not provide a medical evaluation to determine the employee's ability to use a respirator, before the employee was fit tested or required to use the respirator in the workplace: a) Scalabrini Villa Skilled Nursing & Rehabilitation Center located at 860 North Quidnessett Rd., North Kingstown, RI: On or about 6/24/2020, the employer did not provide a medical evaluation to determine each employee's ability to use a respirator before requiring respirator use. The employer required employees to wear respirators while providing care to suspected and confirmed positive COVID-19 residents.
Citation ID 01001C
Citaton Type Serious
Standard Cited 19100134 F02
Issuance Date 2020-12-23
Abatement Due Date 2021-01-27
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2021-01-21
Nr Instances 1
Nr Exposed 68
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.134(f)(2): Employee(s) using tight-fitting facepiece respirators were not fit tested prior to initial use of the respirator: a) Scalabrini Villa Skilled Nursing & Rehabilitation Center located at 860 North Quidnessett Rd., North Kingstown, RI: On or about 6/24/2020, the employer did not provide a fit test to all employees who were required to wear respirators. The employer required employees to wear N95 filtering facepiece respirators to protect against the SARS-CoV-2 virus while providing care to suspected and confirmed positive COVID-19 residents.
314915596 0112300 2010-01-21 860 NORTH QUIDNESSETT ROAD, NORTH KINGSTOWN, RI, 02852
Inspection Type Planned
Scope Partial
Safety/Health Safety
Close Conference 2011-01-12
Emphasis L: ERGONOMIC, N: NURSING, N: RKNEP
Case Closed 2011-07-12

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
05-0449292 Corporation Unconditional Exemption 860 N QUIDNESSETT RD, N KINGSTOWN, RI, 02852-1000 1991-04
In Care of Name -
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 Religious Organization
Deductibility Contributions are deductible.
Foundation Church 170(b)(1)(A)(i)
Tax Period -
Asset 0
Income 0
Filing Requirement 990 - Not required to file (church)
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount -
Income Amount -
Form 990 Revenue Amount -
National Taxonomy of Exempt Entities -
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)

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1278368809 2021-04-10 0165 PPS 860 N Quidnessett Rd, North Kingstown, RI, 02852-1000
Loan Status Date 2021-09-21
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 962500
Loan Approval Amount (current) 962500
Undisbursed Amount 0
Franchise Name -
Lender Location ID 65777
Servicing Lender Name The Washington Trust Company of Westerly
Servicing Lender Address 23 Broad St, WESTERLY, RI, 02891-1879
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address North Kingstown, WASHINGTON, RI, 02852-1000
Project Congressional District RI-02
Number of Employees 81
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 65777
Originating Lender Name The Washington Trust Company of Westerly
Originating Lender Address WESTERLY, RI
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 965681.6
Forgiveness Paid Date 2021-08-11
9178957006 2020-04-09 0165 PPP 860 N QUIDNESSETT RD, WESTERLY, RI, 02852-1000
Loan Status Date 2021-06-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1075000
Loan Approval Amount (current) 1075000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 65777
Servicing Lender Name The Washington Trust Company of Westerly
Servicing Lender Address 23 Broad St, WESTERLY, RI, 02891-1879
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WESTERLY, WASHINGTON, RI, 02852-1000
Project Congressional District RI-02
Number of Employees 111
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 65777
Originating Lender Name The Washington Trust Company of Westerly
Originating Lender Address WESTERLY, RI
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 1086287.5
Forgiveness Paid Date 2021-05-10

Related by officers

REV. HORECIO CARLOS ANKLAN CS

The Pious Society of the Missionaries of St. Charles Boromeo, Inc. Blessed John Baptist Scalabrini Residence, Inc.

REV. SERGIO DALLAGNESE CS

The Pious Society of the Missionaries of St. Charles Boromeo, Inc. Blessed John Baptist Scalabrini Residence, Inc.

REV. JEFFERSON ORLANDO BARIVIERA CS

The Pious Society of the Missionaries of St. Charles Boromeo, Inc. Blessed John Baptist Scalabrini Residence, Inc.

REV. RUBENS SYLVAIN CS

The Pious Society of the Missionaries of St. Charles Boromeo, Inc. Blessed John Baptist Scalabrini Residence, Inc.

REV. MAURIZIO MAIFREDI CS

The Pious Society of the Missionaries of St. Charles Boromeo, Inc. Blessed John Baptist Scalabrini Residence, Inc.

FELIMON RODRIGUEZ SIXTOS

The Pious Society of the Missionaries of St. Charles Boromeo, Inc. Blessed John Baptist Scalabrini Residence, Inc.

Related by address

860 NORTH QUIDNESSETT RD, NORTH KINGSTOWN, RI, 02852, USA

Blessed John Baptist Scalabrini Residence, Inc.

Date of last update: 07 Apr 2025

Sources: Rhode Island Department of State

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