| Name: | ATHENA ORCHARD VIEW LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 09 Jan 2012 (13 years ago) |
| Identification Number: | 000762561 |
| ZIP code: | 02915 |
| County: | Providence County |
| Principal Address: | 135 TRIPPS LANE, EAST PROVIDENCE, RI, 02915, USA |
| Purpose: | TO OPERATE A NURSING HOME FACILITY LOCATED IN EAST PROVIDENCE RHODE ISLAND |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Orchard View Manor Rehabilitation & Nursing Center (trading name, 2013-10-22 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831443779 | 2012-10-30 | 2023-02-16 | 135 TRIPPS LANE, EAST PROVIDENCE, RI, 029153017, US | 135 TRIPPS LANE, EAST PROVIDENCE, RI, 029153017, US | |||||||||||||||||||||
|
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| Phone | +1 401-438-2250 |
| Fax | 4014380635 |
Authorized person
| Name | LAWRENCE G. SANTILLI |
| Role | MANAGER |
| Phone | 8607513900 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | AT94610 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| LAWRENCE G. SANTILLI | Manager | 135 SOUTH ROAD FARMINGTON, CT 06032 USA |
| Number | Name | File Date |
|---|---|---|
| 202451823030 | Annual Report | 2024-04-22 |
| 202334347260 | Annual Report | 2023-04-27 |
| 202221403260 | Annual Report | 2022-07-18 |
| 202219172170 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202103376460 | Annual Report | 2021-10-18 |
| 202060249670 | Annual Report | 2020-10-02 |
| 201926830210 | Annual Report | 2019-11-05 |
| 201984545190 | Annual Report | 2019-01-16 |
| 201749300220 | Annual Report | 2017-09-05 |
| 201608449950 | Annual Report | 2016-09-06 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | 36C24124K0184 | 2023-12-08 | 2024-09-30 | 2024-09-30 | |||||||||||||||||||||||||
|
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| Obligated Amount | 2135330.76 |
| Current Award Amount | 2135330.76 |
| Potential Award Amount | 2135330.76 |
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 | ATHENA ORCHARD VIEW LLC |
| UEI | U45MMCZZTP11 |
| Recipient Address | UNITED STATES, 135 TRIPPS LANE, EAST PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029153017 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
