| Name: | 70 GILL AVENUE OPERATIONS LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Cancelled |
| Date of Organization in Rhode Island: | 14 Aug 2008 (16 years ago) |
| Date of Dissolution: | 27 Feb 2024 (a year ago) |
| Date of Status Change: | 27 Feb 2024 (a year ago) |
| Identification Number: | 000485356 |
| Place of Formation: | DELAWARE |
| Principal Address: | 101 EAST STATE STREET, KENNETT SQUARE, PA, 19348, USA |
| Mailing Address: | 101 E. STATE STREET, KENNETT SQUARE, PA, 19348, USA |
| Purpose: | OPERATOR OF HEALTHCARE FACILITY |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Pawtucket Skilled Nursing and Rehabilitation (trading name, 2008-08-28 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184875791 | 2008-10-02 | 2020-07-23 | 70 GILL AVE, PAWTUCKET, RI, 028614315, US | 70 GILL AVE, PAWTUCKET, RI, 028614315, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-722-7900 |
| Fax | 4017239670 |
Authorized person
| Name | MICHAEL T BERG |
| Role | CORPORATE OFFICER |
| Phone | 5054684742 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00736 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | GA75165 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| SEAN STEVENSON | Manager | 101 E STATE STREET KENNETT SQUARE, PA 19348 USA |
| KEITH NAUSE | Manager | 101 E STATE STREET KENNETT SQUARE, PA 19348 USA |
| MICHAEL S SHERMAN | Manager | 101 E. STATE STREET KENNETT SQUARE, PA 19348 USA |
| STEPHEN S YOUNG | Manager | 101 E. STATE STREET KENNETT SQUARE, PA 19348 USA |
| MICHAEL BERG | Manager | 101 E. STATE STREET KENNETT SQUARE, PA 19348 USA |
| Number | Name | File Date |
|---|---|---|
| 202447384060 | Certificate of Cancellation | 2024-02-27 |
| 202331393620 | Annual Report | 2023-03-22 |
| 202220602150 | Annual Report | 2022-06-28 |
| 202219337560 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202102786710 | Annual Report | 2021-10-06 |
| 202066658430 | Annual Report | 2020-10-20 |
| 201924959490 | Annual Report | 2019-10-22 |
| 201879742570 | Annual Report | 2018-10-19 |
| 201751709550 | Annual Report | 2017-10-24 |
| 201752147090 | Amendment to Application for Registration | 2017-10-24 |
Date of last update: 13 Oct 2024
Sources: Rhode Island Department of State
