| Name: | 10 WOODLAND DRIVE OPERATIONS LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Aug 2008 (16 years ago) |
| Identification Number: | 000485357 |
| 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: |
Respiratory and Rehabilitation Center of Rhode Island (trading name, 2018-11-13 - ) Coventry Skilled Nursing and Rehabilitation (trading name, 2008-08-28 - 2018-11-13) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912158528 | 2008-10-02 | 2018-11-14 | 10 WOODLAND DR, COVENTRY, RI, 028166716, US | 10 WOODLAND DR, COVENTRY, RI, 028166716, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 401-826-2000 |
| Fax | 4018210260 |
Authorized person
| Name | MICHAEL T BERG |
| Role | ASST SECRETARY |
| Phone | 5054684742 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00732 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | WD75163 |
| 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 |
|---|---|---|
| 202450246290 | Annual Report | 2024-04-05 |
| 202331382480 | Annual Report | 2023-03-22 |
| 202220601900 | Annual Report | 2022-06-28 |
| 202218810640 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202102784400 | Annual Report | 2021-10-06 |
| 202066641900 | Annual Report | 2020-10-20 |
| 201924917030 | Annual Report | 2019-10-21 |
| 201881094160 | Fictitious Business Name Statement | 2018-11-13 |
| 201881094520 | Statement of Abandonment of Use of Fictitious Business Name | 2018-11-13 |
| 201879728510 | Annual Report | 2018-10-19 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | 36C24124K0187 | 2024-02-01 | 2024-09-30 | 2024-09-30 | |||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Obligated Amount | 666417.93 |
| Current Award Amount | 666417.93 |
| Potential Award Amount | 666417.93 |
Description
| Title | EXPRESS REPORT: CNH |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | 10 WOODLAND DRIVE OPERATIONS LLC |
| UEI | FLKPMNHLWGT3 |
| Recipient Address | UNITED STATES, 10 WOODLAND DR, COVENTRY, KENT, RHODE ISLAND, 028166716 |
| Unique Award Key | CONT_AWD_36C24124K0194_3600_36C24121G0003_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 258742.07 |
| Current Award Amount | 258742.07 |
| Potential Award Amount | 258742.07 |
Description
| Title | EXPRESS REPORT: CNH |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | 10 WOODLAND DRIVE OPERATIONS LLC |
| UEI | FLKPMNHLWGT3 |
| Recipient Address | UNITED STATES, 10 WOODLAND DR, COVENTRY, KENT, RHODE ISLAND, 028166716 |
Date of last update: 13 Oct 2024
Sources: Rhode Island Department of State
