| Name: | Thundermist Health Center |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 16 May 1974 (51 years ago) |
| Identification Number: | 000026279 |
| ZIP code: | 02886 |
| County: | Kent County |
| Principal Address: | 171 SERVICE AVENUE, WARWICK, RI, 02886, USA |
| Purpose: | PRIVATE, NONPROFIT, COMPREHENSIVE COMMUNITY HEALTH CENTER |
| NAICS: | 621498 - All Other Outpatient Care Centers |
| Fictitious names: |
Thundermist Health Center of Woonsocket (trading name, 2002-08-13 - ) Thundermist Health Center for Women & Children (trading name, 2002-08-13 - ) Thundermist Health Center of South County (trading name, 2002-08-13 - ) |
| Historical names: |
Health Services Incorporated THUNDERMIST HEALTH ASSOCIATES, INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265190292 | 2021-12-07 | 2021-12-07 | 25 JOHN A CUMMINGS WAY, WOONSOCKET, RI, 028953244, US | 360 KINGSTOWN RD UNIT 101, NARRAGANSETT, RI, 028823258, US | |||||||||||||||||||
|
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| Phone | +1 401-767-4100 |
| Fax | 4012356833 |
Authorized person
| Name | DAKOTAH MICHELE BOWEN |
| Role | CREDENTIALING LEAD |
| Phone | 4017674100 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QF0400X - Federally Qualified Health Center (FQHC) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JEANNE LACHANCE | Agent | 171 SERVICE AVENUE BUILDING 2, WARWICK, RI, 02886, USA |
| Name | Role | Address |
|---|---|---|
| MARY ELLEN CANIGLIA | DIRECTOR | 31 TABER STREET WEST KINGSTON, RI 02892 USA |
| TIMOTHY HENRY | DIRECTOR | 25 CLIFF AVENUE CRANSTON, RI 02920 USA |
| DAVID VALOIS | DIRECTOR | ONE CVS DRIVE WOONSOCKET, RI 02895 USA |
| ANDREA ROLLIN | DIRECTOR | 19 PROVIDENCE STREET WEST WARWICK, RI 02893 USA |
| LAWRENCE TRIM | DIRECTOR | 2 FAIRWAY DRIVE BARRINGTON, RI 02806 USA |
| SARAH DELAPORTA MD | DIRECTOR | 18 CLARK MILL STREET COVENTRY, RI 02816 USA |
| CHERYL KING | DIRECTOR | 1207 MENDON ROAD WOONSOCKET, RI 02895 USA |
| DONALD LARSEN | DIRECTOR | 160 HUNTS AVENUE PAWTUCKET, RI 02861 USA |
| MADRONE PHOENIX | DIRECTOR | 127 LITTLE REST ROAD KINGSTON, RI 02881 USA |
| Name | Role | Address |
|---|---|---|
| LINDA CANNISTRA | SECRETARY | 87 RIDGE ROAD SMITHFIELD, RI 02917 USA |
| Name | Role | Address |
|---|---|---|
| JEANNE LACHANCE | PRESIDENT & CEO | 171 SERVICE AVENUE WARWICK, RI 02886 USA |
| Name | Role | Address |
|---|---|---|
| M. DOUGLAS FAY | TREASURER | 13 HOWE STREET BRISTOL, RI 02809 USA |
| Name | Role | Address |
|---|---|---|
| VICTORIA GERMAIN | VICE CHAIRPERSON | 89 OAK STREET WESTERLY, RI 02891 USA |
| Name | Role | Address |
|---|---|---|
| ERIN COONEY | CHAIRPERSON | 729B WASHINGTON STREET COVENTRY, RI 02816 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2002-07-18 | THUNDERMIST HEALTH ASSOCIATES, INC. | Thundermist Health Center |
| Merged | 2002-07-18 | HEALTH CENTER OF SOUTH COUNTY, INC. on | Thundermist Health Center |
| Name Change | 1988-08-23 | Health Services Incorporated | THUNDERMIST HEALTH ASSOCIATES, INC. |
| Number | Name | File Date |
|---|---|---|
| 202449636680 | Annual Report | 2024-03-28 |
| 202328770210 | Annual Report | 2023-02-17 |
| 202209751710 | Annual Report | 2022-02-08 |
| 202198538460 | Annual Report | 2021-06-22 |
| 202041793060 | Annual Report | 2020-06-10 |
| 201995596800 | Annual Report | 2019-06-06 |
| 201869682770 | Annual Report | 2018-06-15 |
| 201743680210 | Annual Report | 2017-05-26 |
| 201743464180 | Statement of Change of Registered/Resident Agent | 2017-05-23 |
| 201699188680 | Annual Report | 2016-05-20 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
