| Name: | FOREST FARM HEALTH CARE CENTER I, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 04 Apr 2003 (22 years ago) |
| Date of Dissolution: | 14 Aug 2018 (7 years ago) |
| Date of Status Change: | 14 Aug 2018 (7 years ago) |
| Identification Number: | 000131086 |
| ZIP code: | 02842 |
| County: | Newport County |
| Principal Address: | 201 FOREST AVENUE, MIDDLETOWN, RI, 02842, USA |
| Mailing Address: | 193 FOREST AVENUE, MIDDLETOWN, RI, 02842, USA |
| Purpose: | MULTI USE BUILDING |
NAICS
531110 Lessors of Residential Buildings and DwellingsThis industry comprises establishments primarily engaged in acting as lessors of buildings used as residences or dwellings, such as single-family homes, apartment buildings, and town homes. Included in this industry are owner-lessors and establishments renting real estate and then acting as lessors in subleasing it to others. The establishments in this industry may manage the property themselves or have another establishment manage it for them. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184714602 | 2006-10-13 | 2020-08-22 | 201 FOREST AVE, MIDDLETOWN, RI, 028424625, US | 201 FOREST AVE, MIDDLETOWN, RI, 028424625, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-847-2777 |
| Fax | 4018487403 |
Authorized person
| Name | MR. KARL H LYON |
| Role | ADMINISTRATOR OWNER |
| Phone | 4018472777 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | ALR01308 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 00737 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | FF03657 |
| State | RI |
| Issuer | MEDICAID |
| Number | FF40453 |
| State | RI |
| Issuer | MEDICAID |
| Number | 4105040 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| KARL H. LYON, JR. | Agent | 201 FOREST AVENUE, MIDDLETOWN, RI, 02842, USA |
| Number | Name | File Date |
|---|---|---|
| 201874492740 | Articles of Dissolution | 2018-08-14 |
| 201874492290 | Annual Report | 2018-08-14 |
| 201874491590 | Reinstatement | 2018-08-14 |
| 201873275100 | Revocation Certificate For Failure to File the Annual Report for the Year | 2018-07-30 |
| 201865706010 | Revocation Notice For Failure to File An Annual Report | 2018-05-15 |
| 201609405720 | Annual Report | 2016-09-26 |
| 201582313650 | Annual Report | 2015-10-13 |
| 201446135800 | Annual Report | 2014-09-17 |
| 201435567290 | Annual Report | 2014-02-14 |
| 201433593110 | Revocation Notice For Failure to File An Annual Report | 2014-01-17 |
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
