| Name: | PARK AVENUE SENIOR CARE, INC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Jan 2015 (10 years ago) |
| Identification Number: | 001041338 |
| ZIP code: | 02910 |
| County: | Providence County |
| Principal Address: | 1049 PARK AVENUE, CRANSTON, RI, 02910, USA |
| Purpose: | ADULT DAY HEALTH CARE CENTER: A STRUCTURED PROGRAM ASSISTING WITH COGNITIVE, PHYSICAL AND SOCIAL NEEDS FOR SENIORS AND ADULTS NEEDING ASSISTANCE. Title: 7-1.2-1701 |
| NAICS: | 624120 - Services for the Elderly and Persons with Disabilities |
| Historical names: |
Lighthouse Senior Care, Inc PARK AVENUE SENOIR CARE INC |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922556166 | 2016-09-16 | 2016-09-16 | 1047 PARK AVE, CRANSTON, RI, 029103238, US | 1047 PARK AVE, CRANSTON, RI, 029103238, US | |||||||||||||||||
|
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| Phone | +1 401-946-7275 |
| Fax | 4019467276 |
Authorized person
| Name | MRS. KIMBERLY W SANTILLI |
| Role | ADMINISTRATOR |
| Phone | 4019467275 |
Taxonomy
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KIMBERLY W. SANTILLI | Agent | 1049 PARK AVENUE, CRANSTON, RI, 02910, USA |
| Name | Role | Address |
|---|---|---|
| IRENE QI | PRESIDENT | 1049 PARK AVENUE CRANSTON, RI 02910 USA |
| Name | Role | Address |
|---|---|---|
| LUNING SUN | VICE PRESIDENT | 1049 PARK AVE CRANSTON, RI 02910 USA |
| Name | Role | Address |
|---|---|---|
| KIMBERLY WYNN SANTILLI | ADMINISTRATOR | 1049 PARK AVENUE CRANSTON, RI 02910 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2015-04-28 | PARK AVENUE SENOIR CARE INC | PARK AVENUE SENIOR CARE, INC |
| Name Change | 2015-03-19 | Lighthouse Senior Care, Inc | PARK AVENUE SENOIR CARE INC |
| Number | Name | File Date |
|---|---|---|
| 202446174950 | Annual Report | 2024-02-12 |
| 202331581360 | Annual Report | 2023-03-24 |
| 202331428430 | Statement of Change of Registered/Resident Agent | 2023-03-23 |
| 202208502160 | Annual Report | 2022-01-24 |
| 202184667770 | Annual Report | 2021-01-06 |
| 202030933280 | Annual Report | 2020-01-02 |
| 201984340100 | Annual Report | 2019-01-14 |
| 201984211860 | Statement of Change of Registered/Resident Agent Office | 2019-01-11 |
| 201983633050 | Revocation Notice For Failure to Maintain a Registered Office | 2019-01-03 |
| 201883421900 | Registered Office Not Maintained | 2018-12-24 |
Date of last update: 20 Oct 2024
Sources: Rhode Island Department of State
