| Name: | Island Health and Rehab LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 31 Jan 2020 (5 years ago) |
| Date of Dissolution: | 22 May 2023 (2 years ago) |
| Date of Status Change: | 22 May 2023 (2 years ago) |
| Identification Number: | 001704338 |
| ZIP code: | 02915 |
| County: | Providence County |
| Principal Address: | 100 WAMPANOAG TRAIL, RIVERSIDE, RI, 02915, USA |
| Purpose: | NURSING HOME |
| NAICS: | 623110 - Nursing Care Facilities (Skilled Nursing Facilities) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154956969 | 2020-03-12 | 2021-08-31 | 100 WAMPANOAG TRL, RIVERSIDE, RI, 029153736, US | 100 WAMPANOAG TRL, RIVERSIDE, RI, 029153736, US | |||||||||||||
|
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| Phone | +1 401-438-4275 |
Authorized person
| Name | MR. FACILITY ADMINISTRATOR |
| Role | ADMINISTRATOR |
| Phone | 4014384275 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ANNIE OCHOA | Agent | 100 WAMPANOAG TRAIL, RIVERSIDE, RI, 02915, USA |
| Number | Name | File Date |
|---|---|---|
| 202335886920 | Revocation Certificate For Failure to Maintain a Registered Office | 2023-05-22 |
| 202330640130 | Revocation Notice For Failure to Maintain a Registered Office | 2023-03-13 |
| 202329027980 | Registered Office Not Maintained | 2023-01-27 |
| 202212536500 | Annual Report | 2022-03-10 |
| 202192803050 | Annual Report | 2021-02-24 |
| 202191295270 | Statement of Change of Registered/Resident Agent | 2021-02-15 |
| 202043882050 | Statement of Change of Registered/Resident Agent | 2020-06-30 |
| 202033471860 | Articles of Organization | 2020-01-31 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
