| Name: | HEATHERWOOD RI LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 16 Oct 2013 (11 years ago) |
| Identification Number: | 000846936 |
| ZIP code: | 02840 |
| County: | Newport County |
| Principal Address: | 398 BELLLEVUE AVENUE, NEWPORT, RI, 02840, USA |
| Purpose: | OPERATE NURSING HOME |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Heatherwood Rehabilitation & Health Care Center (trading name, 2014-11-19 - ) |
| Historical names: |
Athena Heatherwood RI LLC |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427469105 | 2014-05-15 | 2023-02-17 | 398 BELLEVUE AVE, NEWPORT, RI, 028406955, US | 398 BELLEVUE AVE, NEWPORT, RI, 028406955, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-849-6600 |
| Fax | 4018456969 |
Authorized person
| Name | LAWRENCE G. SANTILLI |
| Role | MANAGER |
| Phone | 8607513900 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | LTC00679 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | HE99390 |
| 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 |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2013-11-12 | Athena Heatherwood RI LLC | HEATHERWOOD RI LLC |
| Number | Name | File Date |
|---|---|---|
| 202451821630 | Annual Report | 2024-04-22 |
| 202334357430 | Annual Report | 2023-04-27 |
| 202221404500 | Annual Report | 2022-07-18 |
| 202218716320 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202103378590 | Annual Report | 2021-10-18 |
| 202060257620 | Annual Report | 2020-10-02 |
| 201926831730 | Annual Report | 2019-11-05 |
| 201983985870 | Annual Report | 2019-01-08 |
| 201749299560 | Annual Report | 2017-09-05 |
| 201608449130 | Annual Report | 2016-09-06 |
Date of last update: 18 Oct 2024
Sources: Rhode Island Department of State
