| Name: | Harborside Rhode Island Limited Partnership |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Partnership |
| Status: | Activ |
| Date of Organization in Rhode Island: | 16 Jan 1998 (27 years ago) |
| Identification Number: | 000098914 |
| Place of Formation: | MASSACHUSETTS |
| Principal Address: | 101 E. STATE STREET, KENNETT SQUARE, PA, 19348, USA |
| Purpose: | TO ENGAGE IN THE OWNERSHIP, LEASE AND OPERATION OF NURSING HOMES. |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Greenwood Center (trading name, 2012-12-06 - ) Greenwood Care and Rehabilitation Center (trading name, 2008-10-24 - 2012-12-06) Pawtuxet Village Care and Rehabilitation Center (trading name, 2008-10-24 - ) Harborside Healthcare-Greenwood Rehabilitation &Nursing Center (trading name, 1998-05-27 - ) Harborside Healthcare-Pawtuxet Village Rehabilitation & Nursing Center (trading name, 1998-05-27 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003823626 | 2006-08-03 | 2023-08-29 | 101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM, 871094373, US | 1139 MAIN AVE, WARWICK, RI, 028861940, US | |||||||||||||||||||||||||||||
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| Phone | +1 505-468-5604 |
| Fax | 5054684681 |
| Phone | +1 401-739-6600 |
| Fax | 4017380310 |
Authorized person
| Name | MICHAEL T BERG |
| Role | OFFICER |
| Phone | 5054684742 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC 00709 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | HH26199 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Number | Name | File Date |
|---|---|---|
| 202457994220 | Annual Report | 2024-07-16 |
| 202455962320 | Revocation Notice For Failure to File An Annual Report | 2024-06-18 |
| 201204483790 | Statement of Abandonment of Use of Fictitious Business Name | 2012-12-06 |
| 201204483880 | Fictitious Business Name Statement | 2012-12-06 |
| 200837048390 | Fictitious Business Name Statement | 2008-10-24 |
| 200837048200 | Fictitious Business Name Statement | 2008-10-24 |
| 201881349530 | Statement of Change of Registered/Resident Agent Office | 2004-06-14 |
| 201881349620 | Fictitious Business Name Statement | 1998-05-27 |
| 201881349800 | Fictitious Business Name Statement | 1998-05-27 |
| 201881349990 | Application for Certificate of Registration | 1998-01-16 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
