| 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 |
| Fictitious names: |
South County Nursing and Rehabilitation Center (trading name, 2008-09-17 - ) |
NAICS
623110 Nursing Care Facilities (Skilled Nursing Facilities)This industry comprises establishments primarily engaged in providing inpatient nursing and rehabilitative services. The care is generally provided for an extended period of time to individuals requiring nursing care. These establishments have a permanent core staff of registered or licensed practical nurses who, along with other staff, provide nursing and continuous personal care services. Learn more at the U.S. Census Bureau
| 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 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 310152327 | 0112300 | 2006-08-24 | 740 OAK HILL ROAD, NORTH KINGSTOWN, RI, 02852 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001A |
| Citaton Type | Other |
| Standard Cited | 19101030 F03 V |
| Issuance Date | 2007-03-08 |
| Abatement Due Date | 2007-04-10 |
| Nr Instances | 2 |
| Nr Exposed | 4 |
| Gravity | 01 |
| Citation ID | 01001B |
| Citaton Type | Other |
| Standard Cited | 19101030 F05 |
| Issuance Date | 2007-03-08 |
| Abatement Due Date | 2007-04-10 |
| Nr Instances | 4 |
| Nr Exposed | 4 |
| Gravity | 01 |
| Inspection Type | Planned |
| Scope | Partial |
| Safety/Health | Health |
| Close Conference | 2003-07-09 |
| Emphasis | N: NURSING, S: NURSING HOMES |
| Case Closed | 2003-08-11 |
Violation Items
| Citation ID | 01001A |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 IV |
| Issuance Date | 2003-07-09 |
| Abatement Due Date | 2003-08-25 |
| Nr Instances | 1 |
| Nr Exposed | 7 |
| Gravity | 01 |
| Citation ID | 01001B |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 IVB |
| Issuance Date | 2003-07-09 |
| Abatement Due Date | 2003-08-25 |
| Nr Instances | 1 |
| Nr Exposed | 7 |
| Gravity | 01 |
| Citation ID | 01001C |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 V |
| Issuance Date | 2003-07-09 |
| Abatement Due Date | 2003-08-25 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| Gravity | 01 |
| Citation ID | 01002 |
| Citaton Type | Other |
| Standard Cited | 19101030 H02 IB |
| Issuance Date | 2003-07-09 |
| Abatement Due Date | 2003-08-25 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| Gravity | 01 |
Date of last update: 10 Oct 2024
Sources: Rhode Island Department of State
