| Name: | 981 KINGS TOWN ROAD OPERATING COMPANY, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 03 Sep 2010 (14 years ago) |
| Identification Number: | 000550776 |
| ZIP code: | 02879 |
| County: | Washington County |
| Place of Formation: | DELAWARE |
| Principal Address: | 55 SCALLOP SHELL WAY, PEACE DALE, RI, 02879, USA |
| Mailing Address: | 641 LEXINGTON AVENUE FLOOR 18, NEW YORK, NY, 10022, USA |
| Purpose: | SKILLED NURSING |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Elderwood of Scallop Shell at Wakefield (trading name, 2016-01-08 - ) Scallop Shell Nursing and Rehabilitation Center (trading name, 2011-01-25 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679874135 | 2010-11-15 | 2023-01-19 | 500 SENECA ST STE 100, BUFFALO, NY, 142041963, US | 55 SCALLOP SHELL WAY, PEACE DALE, RI, 028793045, US | |||||||||||||||||||||
|
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| Phone | +1 716-633-3900 |
| Phone | +1 401-789-3006 |
Authorized person
| Name | DR. JEFFREY RUBIN |
| Role | CO-CHIEF EXECUTIVE OFFICER |
| Phone | 7168175075 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RHODE ISLAND DEPARTMENT OF HEALTH |
| Number | LTC00352 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| WARREN COLE | MANAGER | 641 LEXINGTON AVENUE, FLOOR 18 NEW YORK, NY 10022 USA |
| JEFFREY RUBIN | MANAGER | 641 LEXINGTON AVENUE, FLOOR 18 NEW YORK, NY 10022 USA |
| Number | Name | File Date |
|---|---|---|
| 202449978780 | Annual Report | 2024-04-02 |
| 202332309350 | Annual Report | 2023-04-04 |
| 202209848960 | Annual Report | 2022-02-09 |
| 202102464960 | Annual Report | 2021-10-01 |
| 202053830490 | Annual Report | 2020-09-11 |
| 201917218650 | Annual Report | 2019-09-03 |
| 201876770990 | Annual Report | 2018-09-06 |
| 201749248810 | Annual Report | 2017-09-06 |
| 201608269530 | Annual Report | 2016-09-01 |
| 201690254050 | Fictitious Business Name Statement | 2016-01-08 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
