| Name: | CPL (SOUTH COUNTY) LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 16 May 2006 (19 years ago) |
| Date of Dissolution: | 22 Jul 2019 (6 years ago) |
| Date of Status Change: | 22 Jul 2019 (6 years ago) |
| Identification Number: | 000156045 |
| ZIP code: | 02852 |
| County: | Washington County |
| Place of Formation: | DELAWARE |
| Principal Address: | 740 OAK HILL ROAD, NORTH KINGSTOWN, RI, 02852, USA |
| Mailing Address: | 538 PRESTON AVENUE SUITE 270, MERIDEN, CT, 06450, USA |
| Purpose: | OWN AND OPERATE A NURSING FACILITY |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
South County Nursing and Rehabilitation Center (trading name, 2008-09-17 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1881716686 | 2007-04-04 | 2011-08-15 | 538 PRESTON AVENUE, SUITE 270, MERIDEN, CT, 064504851, US | 740 OAK HILL ROAD, NORTH KINGSTOWN, RI, 028527205, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 203-608-6100 |
| Fax | 2036393574 |
| Phone | +1 401-294-4545 |
| Fax | 4012957650 |
Authorized person
| Name | CAROLE M SCILLIA |
| Role | LLC MANAGER |
| Phone | 2036086100 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00678 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00746 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTS00746 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RI BLUE CHIP |
| Number | 401028 |
| State | RI |
| Issuer | MEDICAID |
| Number | 4105071 |
| State | RI |
| Issuer | MEDICAID |
| Number | CP66176 |
| State | RI |
| Issuer | UNITED HEALTH CARE |
| Number | 7100217 |
| State | RI |
| Issuer | BC & BS OF RI |
| Number | 5044-3 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Number | Name | File Date |
|---|---|---|
| 201906311940 | Revocation Certificate For Failure to File the Annual Report for the Year | 2019-07-22 |
| 201992897720 | Revocation Notice For Failure to File An Annual Report | 2019-05-13 |
| 201857918090 | Annual Report | 2018-02-09 |
| 201603303950 | Annual Report | 2016-08-08 |
| 201582390390 | Annual Report | 2015-10-14 |
| 201449066660 | Annual Report | 2014-10-29 |
| 201329557200 | Annual Report | 2013-10-17 |
| 201324515070 | Statement of Change of Registered/Resident Agent Office | 2013-06-17 |
| 201312570830 | Statement of Change of Registered/Resident Agent Office | 2013-02-12 |
| 201202002290 | Annual Report | 2012-10-25 |
Date of last update: 10 Oct 2024
Sources: Rhode Island Department of State
