| 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)This industry comprises establishments primarily engaged in providing inpatient nursing and rehabilitative services. The care is generally provided for an extended period of time to individuals requiring nursing care. These establishments have a permanent core staff of registered or licensed practical nurses who, along with other staff, provide nursing and continuous personal care services. Learn more at the U.S. Census Bureau
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3423938603 | 2021-03-17 | 0165 | PPP | 100 Wampanoag Trl, Riverside, RI, 02915-3736 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
