| Name: | Haven Health Center of Greenville, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 03 Mar 2003 (22 years ago) |
| Date of Dissolution: | 26 Feb 2009 (16 years ago) |
| Date of Status Change: | 26 Feb 2009 (16 years ago) |
| Branch of: | Haven Health Center of Greenville, LLC, CONNECTICUT (Company Number 0730486) |
| Identification Number: | 000130309 |
| Place of Formation: | CONNECTICUT |
| Principal Address: | 245 LONG HILL ROAD, MIDDLETOWN, CT, 06457, USA |
| Purpose: | OWN AND OPERATE NURSING HOMES |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992760672 | 2006-04-18 | 2007-12-28 | 735 PUTNAM PIKE, GREENVILLE, RI, 028281435, US | 735 PUTNAM PIKE, GREENVILLE, RI, 028281435, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 401-949-1200 |
| Fax | 4019491204 |
Authorized person
| Name | PAULA BLOOM |
| Role | DIRECTOR OF AR |
| Phone | 8603443884 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00734 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | HH00734 |
| State | RI |
| Number | Name | File Date |
|---|---|---|
| 200943039370 | Revocation Certificate For Failure to Maintain a Registered Agent | 2009-02-26 |
| 200837998910 | Revocation Notice For Failure to Maintain a Registered Agent | 2008-11-24 |
| 200836448740 | Agent Resigned | 2008-10-16 |
| 200700227530 | Annual Report | 2007-08-21 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 310154927 | 0112300 | 2007-02-01 | 735 PUTNAM PIKE, GREENVILLE, RI, 02828 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19100101 B |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-04-12 |
| Current Penalty | 650.0 |
| Initial Penalty | 1300.0 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 02 |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19100151 C |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-04-19 |
| Current Penalty | 750.0 |
| Initial Penalty | 1500.0 |
| Nr Instances | 2 |
| Nr Exposed | 5 |
| Gravity | 02 |
| Citation ID | 01003A |
| Citaton Type | Serious |
| Standard Cited | 19101030 C01 I |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-05-24 |
| Current Penalty | 1315.0 |
| Initial Penalty | 2625.0 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Gravity | 05 |
| Citation ID | 01003B |
| Citaton Type | Serious |
| Standard Cited | 19101030 D04 IIIA3 |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-04-19 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| Gravity | 02 |
| Citation ID | 01003C |
| Citaton Type | Serious |
| Standard Cited | 19101030 F02 I |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-04-12 |
| Nr Instances | 1 |
| Gravity | 02 |
| Citation ID | 01003D |
| Citaton Type | Serious |
| Standard Cited | 19101030 G02 IV |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-05-24 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Gravity | 02 |
| Citation ID | 01004A |
| Citaton Type | Serious |
| Standard Cited | 19101030 F05 IIA |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-05-24 |
| Current Penalty | 750.0 |
| Initial Penalty | 1500.0 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 02 |
| Citation ID | 01004B |
| Citaton Type | Serious |
| Standard Cited | 19101030 F05 IIB |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-05-24 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 02 |
| Citation ID | 01004C |
| Citaton Type | Serious |
| Standard Cited | 19101030 H01 IIC |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-05-24 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 02 |
| Citation ID | 01004D |
| Citaton Type | Serious |
| Standard Cited | 19101030 H05 I |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-05-03 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 02 |
| Citation ID | 02001 |
| Citaton Type | Other |
| Standard Cited | 19040008 |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-04-12 |
| Nr Instances | 1 |
| Gravity | 00 |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19040029 B07 V |
| Issuance Date | 2007-04-09 |
| Abatement Due Date | 2007-04-12 |
| Nr Instances | 1 |
| Gravity | 00 |
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
