| Name: | Flora Ledge LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 30 Apr 1998 (27 years ago) |
| Date of Dissolution: | 15 Jun 2009 (16 years ago) |
| Date of Status Change: | 15 Jun 2009 (16 years ago) |
| Identification Number: | 000100386 |
| ZIP code: | 02827 |
| County: | Kent County |
| Principal Address: | 2052 PLAINFIELD PIKE, GREENE, RI, 02827, USA |
| Mailing Address: | 2052 PLAINFIELD PIKE, GREENE, RI, 02827-, USA |
| Purpose: | ACQUISITION, DEVELOPMENT, OPERATION AND MANAGEMENT OFWOODPECKER HILL NURSING HOME |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407954126 | 2006-09-20 | 2020-08-22 | 2052 PLAINFIELD PIKE, CPU SUMMIT GENERAL STORE, RI, 028271908, US | 2052 PLAINFIELD PIKE, CPU SUMMIT GENERAL STORE, RI, 028271908, US | |||||||||||||||||||||||||
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| Phone | +1 401-397-7504 |
| Fax | 4013972514 |
Authorized person
| Name | MR. JOHN F. COUTURE |
| Role | OWNER |
| Phone | 4013977504 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00726 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4105839 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JOHN F. COUTURE | Agent | WOODPECKER HILL 2052 PLAINFIELD PIKE, GREENE, RI, 02827-, USA |
| Number | Name | File Date |
|---|---|---|
| 200946383010 | Revocation Certificate For Failure to File the Annual Report for the Year | 2009-06-15 |
| 200944306660 | Revocation Notice For Failure to File An Annual Report | 2009-03-25 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
