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The Rhode Island Free Clinic, Inc.

Company Details

Name: The Rhode Island Free Clinic, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 29 Sep 1998 (27 years ago)
Identification Number: 000102746
ZIP code: 02907
County: Providence County
Principal Address: 655 BROAD STREET, PROVIDENCE, RI, 02907, USA
Purpose: OFFERING HIGH QUALITY PHYSICIAN PRIMARY CARE AND PREVENTATIVE HEALTH SERVICES TO CHILDREN AND ADULTS WHO DO NOT HAVE HEALTH INSURANCE OR CANNOT AFFORD TO PURCHASE SUCH SERVICES.

Industry & Business Activity

NAICS

622110 General Medical and Surgical Hospitals

This industry comprises establishments known and licensed as general medical and surgical hospitals primarily engaged in providing diagnostic and medical treatment (both surgical and nonsurgical) to inpatients with any of a wide variety of medical conditions. These establishments maintain inpatient beds and provide patients with food services that meet their nutritional requirements. These hospitals have an organized staff of physicians and other medical staff to provide patient care services. These establishments usually provide other services, such as outpatient services, anatomical pathology services, diagnostic X-ray services, clinical laboratory services, operating room services for a variety of procedures, and pharmacy services. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1558706267 2013-05-08 2013-05-08 655 BROAD ST, PROVIDENCE, RI, 029071444, US 655 BROAD ST, PROVIDENCE, RI, 029071444, US

Contacts

Phone +1 401-274-6347

Authorized person

Name MS. MARIE GHAZAL
Role CHIEF EXECUTIVE OFFICER
Phone 4012746347

Taxonomy

Taxonomy Code 261Q00000X - Clinic/Center
License Number ACF01570
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RHODE ISLAND FREE CLINIC 403(B) PLAN 2014 050501276 2015-07-27 RHODE ISLAND FREE CLINIC, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 4012746347
Plan sponsor’s address 655 BROAD STREET, PROVIDENCE, RI, 02903

Signature of

Role Plan administrator
Date 2015-07-27
Name of individual signing MARIE GHAZAL
Valid signature Filed with authorized/valid electronic signature
RHODE ISLAND FREE CLINIC 403(B) PLAN 2013 050501276 2014-05-16 RHODE ISLAND FREE CLINIC, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 4012746347
Plan sponsor’s address 655 BROAD STREET, PROVIDENCE, RI, 02903

Signature of

Role Plan administrator
Date 2014-05-16
Name of individual signing MARIE GHAZAL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ANDREW W. DAVIS, ESQ. Agent 101 DYER STREET, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
CARRIE BRIDGES FELIZ, MPH PRESIDENT 335R PRAIRIE AVENUE, SUITE 2B PROVIDENCE , RI 02905 USA

TREASURER

Name Role Address
PATRICK MARTIN, CPA TREASURER KAHN, LITWIN, RENZA 951 N. MAIN STREET, PROVIDENCE, RI 02904 USA

SECRETARY

Name Role Address
DIANA DUCHARME ESQ SECRETARY CERVENKA GREEN & DUCHARME LLC 235 PROMENADE ST. PROVIDENCE, RI 02908 USA

VICE PRESIDENT

Name Role Address
MICHELE LEDERBERG, ESQ. VICE PRESIDENT BLUE CROSS & BLUE SHIELD OF RHODE ISLAND 500 EXCHANGE STREET PROVIDENCE, RI 02903 USA

DIRECTOR

Name Role Address
WILLIAM FITZGERALD DIRECTOR AMICA MUTUAL INSURANCE COMPANY 100 AMICA WAY LINCOLN, RI 02865 USA
MICHELE LEDERBERG, ESQ. DIRECTOR BLUE CROSS & BLUE SHIELD OF RHODE ISLAND 500 EXCHANGE STREET PROVIDENCE, RI 02903 USA
PATRICK MARTIN, CPA DIRECTOR KAHN, LITWIN, RENZA 951 N. MAIN STREET PROVIDENCE, RI 02904 USA
JEFFREY F. CHASE-LUBITZ, ESQ. DIRECTOR ONE RICHMOND SQ., SUITE 165W PROVIDENCE , RI 02906 USA
SAMUEL BRADNER DIRECTOR PEREGRINE GROUP, LLC. 20 NEWMAN AVE,STE 1005 RUMFORD, RI 02916 USA
JEHANNE BJORNEBYE. ESQ. DIRECTOR CVS HEALTH ONE CVS DRIVE, WOONSOCKET , RI 02895 USA
MARINA RODRIGUEZ, MD DIRECTOR 655 BROAD ST. PROVIDENCE , RI 02907 USA
CAROLINE TROISE, MD DIRECTOR ANCHOR MEDICAL ASSOCIATES, 180 CORLISS ST. FL. 2 PROVIDENCE, RI 02904 USA
BRENDAN KANE DIRECTOR PEREGRINE PROPERTY MANAGEMENT 20 NEWMAN AVE STE.1005 RUMFORD, RI 02916 USA
LOREE DUBOIS, CPA, MBA DIRECTOR KAHN LITWIN & RENZA 951 N. MAIN STREET PROVIDENCE, RI 02904 USA

Filings

Number Name File Date
202455166700 Annual Report 2024-05-31
202335830310 Annual Report 2023-05-19
202216329720 Annual Report 2022-04-29
202207913390 Annual Report - Amended 2022-01-12
202198829360 Annual Report 2021-06-30
202041887020 Annual Report 2020-06-11
201997179740 Annual Report 2019-06-17
201985961700 Annual Report 2019-02-05
201985482700 Revocation Notice For Failure to File An Annual Report 2019-01-30
201857086140 Articles of Amendment 2018-01-30

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
05-0501276 Corporation Unconditional Exemption 655 BROAD ST STE 301, PROVIDENCE, RI, 02907-1444 1999-05
In Care of Name % STEPHANIE CHAFEE
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 3018924
Income Amount 2199417
Form 990 Revenue Amount 2199417
National Taxonomy of Exempt Entities Health Care: Ambulatory Health Center, Community Clinic
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name RHODE ISLAND FREE CLINIC INC
EIN 05-0501276
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name RHODE ISLAND FREE CLINIC INC
EIN 05-0501276
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name RHODE ISLAND FREE CLINIC INC
EIN 05-0501276
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name RHODE ISLAND FREE CLINIC INC
EIN 05-0501276
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name RHODE ISLAND FREE CLINIC INC
EIN 05-0501276
Tax Period 201612
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7204727100 2020-04-14 0165 PPP 655 BROAD ST 3RD fL, PROVIDENCE, RI, 02907-1444
Loan Status Date 2021-05-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 125530
Loan Approval Amount (current) 125530
Undisbursed Amount 0
Franchise Name -
Lender Location ID 65777
Servicing Lender Name The Washington Trust Company of Westerly
Servicing Lender Address 23 Broad St, WESTERLY, RI, 02891-1879
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address PROVIDENCE, PROVIDENCE, RI, 02907-1444
Project Congressional District RI-01
Number of Employees 15
NAICS code 621112
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 65777
Originating Lender Name The Washington Trust Company of Westerly
Originating Lender Address WESTERLY, RI
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 126760.89
Forgiveness Paid Date 2021-04-19

Date of last update: 09 Apr 2025

Sources: Rhode Island Department of State