| Name: | Spring Villa, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 18 May 2011 (14 years ago) |
| Identification Number: | 000666750 |
| ZIP code: | 02917 |
| County: | Providence County |
| Principal Address: | 57 MOUNTAINDALE ROAD, SMITHFIELD, RI, 02917, USA |
| Purpose: | ASSISTED LIVING CENTER Title: 7-1.2-1701 |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992128540 | 2014-01-31 | 2014-01-31 | 59 PLEASANT ST, WEST WARWICK, RI, 028935630, US | 59 PLEASANT ST, WEST WARWICK, RI, 028935630, US | |||||||||||||||||||||||
|
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| Phone | +1 401-615-2888 |
Authorized person
| Name | MICHELLE PIANKA |
| Role | VICE PRES |
| Phone | 4012267032 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | ALR01487 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | MEDICAID WAIVER |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SPRING VILLA, INC. 401K PLAN | 2023 | 452348205 | 2024-09-26 | SPRING VILLA, INC. | 9 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-26 |
| Name of individual signing | CRAIG PIANKA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Sponsor’s telephone number | 4016152888 |
| Plan sponsor’s address | 59 PLEASANT STREET, WEST WARWICK, RI, 02895 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-05 |
| Name of individual signing | CRAIG PIANKA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CRAIG PIANKA | Agent | 57 MOUNTAINDALE ROAD, SMITHFIELD, RI, 02917, USA |
| Name | Role | Address |
|---|---|---|
| CRAIG PIANKA | PRESIDENT | 57 MOUNTAINDALE ROAD SMITHFIELD , RI 02917 USA |
| Name | Role |
|---|---|
| CRAIG PIANKA | OTHER OFFICER |
| Number | Name | File Date |
|---|---|---|
| 202446368070 | Annual Report | 2024-02-14 |
| 202332891710 | Annual Report | 2023-04-13 |
| 202209866720 | Annual Report | 2022-02-09 |
| 202184928240 | Annual Report | 2021-01-07 |
| 202035422590 | Annual Report | 2020-02-28 |
| 201983484760 | Annual Report | 2019-01-01 |
| 201858936660 | Annual Report | 2018-02-23 |
| 201730126480 | Annual Report | 2017-01-16 |
| 201691083910 | Annual Report | 2016-01-22 |
| 201691084160 | Annual Report | 2016-01-22 |
Date of last update: 16 Oct 2024
Sources: Rhode Island Department of State
