| Name: | AIDS CARE OCEAN STATE, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 08 Dec 1987 (37 years ago) |
| Identification Number: | 000045192 |
| ZIP code: | 02907 |
| County: | Providence County |
| Principal Address: | 18 PARKIS AVENUE, PROVIDENCE, RI, 02907, USA |
| Purpose: | PROVIDING HOUSING, CASE MANAGEMENT, MEDICAL/NURSING CARE AND PREVENTION TO ADULTS, FAMILIES ADOLESCENTS, AND CHILDREN WHO ARE AFFECTED BY HIV AIDS. |
| NAICS: | 624190 - Other Individual and Family Services |
| Fictitious names: |
Facts Leasing Management Services (FLMS) (trading name, 2013-02-06 - ) Sunrise Community Housing (trading name, 2004-07-12 - ) Family Aids Center for Treatment and Support (F.A.C.T.S.) (trading name, 2004-07-12 - ) |
| Historical names: |
Family AIDS Center for Treatment and Support (FACTS) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700902392 | 2007-03-22 | 2019-05-14 | 18 PARKIS AVE, PROVIDENCE, RI, 029071454, US | 557 BROAD ST, PROVIDENCE, RI, 029071403, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 401-521-3603 |
| Fax | 4018612981 |
| Phone | +1 401-273-1888 |
| Fax | 4014541927 |
Authorized person
| Name | GINA MERCURE |
| Role | COO |
| Phone | 4015213603 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | No |
| Taxonomy Code | 322D00000X - Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | 46853 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1700902392 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| GINA MERCURE | Agent | 18 PARKIS AVENUE, PROVIDENCE, RI, 02907, USA |
| Name | Role | Address |
|---|---|---|
| DAVID ROBERT | VICE PRESIDENT | 360 SHAWOMET AVENUE WARWICK, RI 02889 USA |
| Name | Role | Address |
|---|---|---|
| RAYMOND MALM | SECRETARY | 1180 NARRAGANSETT BLVD CRANSTON, RI 02905 USA |
| Name | Role | Address |
|---|---|---|
| MARC GAUTHIER | DIRECTOR | 25 MOHAWK TRAIL CRANSTON, RI 02921 USA |
| DIANE SIEDLECKI MD | DIRECTOR | 140 WILSON AVENUE WARWICK, RI 02889 USA |
| JOSEPH REUSCH | DIRECTOR | 52 ROBINS WAY WARWICK, RI 02879 USA |
| JAY JOYNES | DIRECTOR | 35 KENYON ST APT 5 PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| B. JOSEPH REDDISH | PRESIDENT | 23 COREY TRAIL ROAD WYOMING, RI 02898 USA |
| Name | Role | Address |
|---|---|---|
| MATTHEW ADAMS | TREASURER | 17 WILDWOOD DRIVE CRANSTON, RI 02920 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1998-03-31 | Family AIDS Center for Treatment and Support (FACTS) | AIDS CARE OCEAN STATE, INC. |
| Merged | 1998-03-31 | Sunrise Community Housing on | AIDS CARE OCEAN STATE, INC. |
| Number | Name | File Date |
|---|---|---|
| 202453225940 | Annual Report - Amended | 2024-04-30 |
| 202453184030 | Annual Report | 2024-04-30 |
| 202334503260 | Annual Report | 2023-04-28 |
| 202218062670 | Annual Report | 2022-06-01 |
| 202198375560 | Annual Report | 2021-06-17 |
| 202042935090 | Annual Report | 2020-06-22 |
| 201992996180 | Annual Report | 2019-05-13 |
| 201870998480 | Annual Report | 2018-06-29 |
| 201747590560 | Statement of Change of Registered/Resident Agent | 2017-07-24 |
| 201745846920 | Annual Report | 2017-06-20 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
