| Name: | THE WHITMARSH CORPORATION |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 22 Oct 1975 (49 years ago) |
| Identification Number: | 000030178 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 1055 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA |
| Purpose: | REHABILITATIVE SERVICES FOR ADOLESCENTS. |
| NAICS: | 624110 - Child and Youth Services |
| Fictitious names: |
Evo Wellness (trading name, 2021-03-25 - ) Whitmarsh House (trading name, 2004-08-17 - ) |
| Historical names: |
ANNEX HOUSE CORPORATION |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578859179 | 2011-06-22 | 2020-03-06 | 1055 N MAIN ST, PROVIDENCE, RI, 029045718, US | 1055 N MAIN ST, PROVIDENCE, RI, 029045718, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-351-7230 |
| Fax | 4014210198 |
Authorized person
| Name | ROBERT M LAROCCO |
| Role | CEO |
| Phone | 4013517230 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| License Number | 404 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 322D00000X - Emotionally Disturbed Childrens' Residential Treatment Facility |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID PROVIDER ID |
| Number | WC70315 |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WHITMARSH HOUSE | 2010 | 510193992 | 2011-10-11 | WHITMARSH CORPORATION | 9 | |||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 510193992 |
| Plan administrator’s name | WHITMARSH CORPORATION |
| Plan administrator’s address | 1055 NORTH MAIN STREET, PROVIDENCE, RI, 02904 |
| Administrator’s telephone number | 4013517230 |
Number of participants as of the end of the plan year
| Active participants | 9 |
| Number of participants with account balances as of the end of the plan year | 9 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-04 |
| Name of individual signing | IVY BOOTH |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 624100 |
| Sponsor’s telephone number | 4013517230 |
| Plan sponsor’s mailing address | 1055 NORTH MAIN STREET, PROVIDENCE, RI, 02904 |
| Plan sponsor’s address | 1055 NORTH MAIN STREET, PROVIDENCE, RI, 02904 |
Plan administrator’s name and address
| Administrator’s EIN | 510193992 |
| Plan administrator’s name | WHITMARSH CORPORATION |
| Plan administrator’s address | 1055 NORTH MAIN STREET, PROVIDENCE, RI, 02904 |
| Administrator’s telephone number | 4013517230 |
Number of participants as of the end of the plan year
| Active participants | 9 |
| Number of participants with account balances as of the end of the plan year | 9 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-07 |
| Name of individual signing | IVY BOOTH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ROBERT LAROCCO | Agent | 1055 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA |
| Name | Role | Address |
|---|---|---|
| JOHN HAYNES | PRESIDENT | 10 CALISTO DR REHOBOTH, MA 02769 USA |
| Name | Role | Address |
|---|---|---|
| CHRISTOPHER GUILLEMETTE | TREASURER | 15 WOODLAND RD EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| JONATHAN RILEY | SECRETARY | 56 MOUNTAIN LAUREL WAY NORTH KINGSTOWN, RI 02852 USA |
| Name | Role | Address |
|---|---|---|
| JONATHAN RILEY | VICE PRESIDENT | 56 MOUNTAIN LAUREL WAY NORTH KINGSTOWN, RI 02852 USA |
| Name | Role | Address |
|---|---|---|
| KEVIN FUSCO | DIRECTOR | 18 JENNIFER LANE FOXBORO, MA 02035 USA |
| DANIEL O'GRADY | DIRECTOR | 5 LONGUE VUE AVE NORTH PROVIDENCE, RI 02904 USA |
| BRUCE CIUMMO | DIRECTOR | 28 SAMOSET AVE BARRINGTON, RI 02806 USA |
| ROBERT LAROCCO | DIRECTOR | 20 KING PHILLIP DR NORTH KINGSTOWN, RI 02852 USA |
| LAUREN JOHNSON | DIRECTOR | 585 SPRING LAKE RD GLENDALE, RI 02826 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Merged | 1985-05-29 | YOUTH HOMES, INC. on | THE WHITMARSH CORPORATION |
| Name Change | 1977-02-18 | ANNEX HOUSE CORPORATION | THE WHITMARSH CORPORATION |
| Number | Name | File Date |
|---|---|---|
| 202452565920 | Annual Report | 2024-04-25 |
| 202330339520 | Annual Report | 2023-03-09 |
| 202214607640 | Annual Report | 2022-04-13 |
| 202198332400 | Annual Report | 2021-06-16 |
| 202194954480 | Fictitious Business Name Statement | 2021-03-25 |
| 202053233750 | Annual Report | 2020-09-09 |
| 201996521360 | Annual Report | 2019-06-13 |
| 201996521540 | Statement of Change of Registered/Resident Agent | 2019-06-13 |
| 201874113780 | Statement of Change of Registered/Resident Agent | 2018-08-09 |
| 201867886170 | Annual Report | 2018-05-31 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
