| Name: | Pawtucket SNF Operator, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 15 Nov 2019 (5 years ago) |
| Identification Number: | 001701963 |
| ZIP code: | 02861 |
| County: | Providence County |
| Principal Address: | 70 GILL AVENUE, PAWTUCKET, RI, 02861, USA |
| Mailing Address: | 338 WHITESVILLE RD BLDG 5 STE 501, JACKSON, NJ, 08527, USA |
| Purpose: | SKILLED NURSING FACILITY |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| Fictitious names: |
Pawtucket Falls Healthcare Center (trading name, 2020-03-16 - 2024-02-23) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285242610 | 2020-07-22 | 2020-07-22 | 70 GILL AVE, PAWTUCKET, RI, 028614315, US | 70 GILL AVE, PAWTUCKET, RI, 028614315, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 401-722-7900 |
Authorized person
| Name | JEFFREY KAGAN |
| Role | OWNER |
| Phone | 4108776630 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Name | Role | Address |
|---|---|---|
| STARLIGHT HEALTH CARE | MANAGER | 15 AMERICA AVE LAKEWOOD, NJ 08701 USA |
| Number | Name | File Date |
|---|---|---|
| 202455144960 | Annual Report | 2024-05-31 |
| 202447105700 | Statement of Abandonment of Use of Fictitious Business Name | 2024-02-23 |
| 202336036180 | Annual Report | 2023-05-24 |
| 202218390520 | Annual Report | 2022-06-08 |
| 202100163540 | Annual Report | 2021-08-16 |
| 202187216920 | Annual Report | 2021-01-19 |
| 202036421420 | Fictitious Business Name Statement | 2020-03-16 |
| 201927543560 | Articles of Organization | 2019-11-15 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
