| Name: | Kingston Hill Academy |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 05 Nov 2001 (23 years ago) |
| Identification Number: | 000121150 |
| ZIP code: | 02874 |
| County: | Washington County |
| Principal Address: | 850 STONY FORT ROAD, SAUNDERSTOWN, RI, 02874, USA |
| Purpose: | DEVELOP, ESTABLISH AND OPERATE A CHARTER SCHOOL |
| NAICS: | 611110 - Elementary and Secondary Schools |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801911565 | 2007-03-20 | 2024-10-10 | 610 MANTON AVE, PROVIDENCE, RI, 029095633, US | 850 STONY FORT RD, SAUNDERSTOWN, RI, 028741003, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 401-274-6310 |
| Fax | 4014211077 |
Authorized person
| Name | MARCELLA TERRANOVA CLARK |
| Role | CHIEF ADMINISTRATOR |
| Phone | 4017838282 |
Taxonomy
| Taxonomy Code | 251300000X - Local Education Agency (LEA) |
| Is Primary | Yes |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | KH46123 |
| State | RI |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2549003HKZOPV8B6J238 | 000121150 | US-RI | GENERAL | ACTIVE | No data | |||||||||||||||||||
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| Legal | 850 Stony Fort Road, Saunderstown, US-RI, US, 02874 |
| Headquarters | 850 Stony Fort Road, Saunderstown, US-RI, US, 02874 |
Registration details
| Registration Date | 2019-08-05 |
| Last Update | 2022-03-11 |
| Status | LAPSED |
| Next Renewal | 2020-08-05 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | 000121150 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KINGSTON HILL ACADEMY TAX-DEFERRED ANNUITY PLAN | 2011 | 050520887 | 2012-10-10 | KINGSTON HILL ACADEMY | 3 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 050520887 |
| Plan administrator’s name | KINGSTON HILL ACADEMY |
| Plan administrator’s address | 610 MANTON AVENUE, PROVIDENCE, RI, 02909 |
| Administrator’s telephone number | 4012746310 |
Signature of
| Role | Plan administrator |
| Date | 2012-09-28 |
| Name of individual signing | HELEN MORCOS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2002-07-01 |
| Business code | 611000 |
| Sponsor’s telephone number | 4012746310 |
| Plan sponsor’s address | 610 MANTON AVENUE, PROVIDENCE, RI, 02909 |
Plan administrator’s name and address
| Administrator’s EIN | 050520887 |
| Plan administrator’s name | KINGSTON HILL ACADEMY |
| Plan administrator’s address | 610 MANTON AVENUE, PROVIDENCE, RI, 02909 |
| Administrator’s telephone number | 4012746310 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-27 |
| Name of individual signing | HELEN MORCOS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2002-07-01 |
| Business code | 611000 |
| Sponsor’s telephone number | 4012746310 |
| Plan sponsor’s address | 610 MANTON AVENUE, PROVIDENCE, RI, 02909 |
Plan administrator’s name and address
| Administrator’s EIN | 050520887 |
| Plan administrator’s name | KINGSTON HILL ACADEMY |
| Plan administrator’s address | 610 MANTON AVENUE, PROVIDENCE, RI, 02909 |
| Administrator’s telephone number | 4012746310 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-20 |
| Name of individual signing | HELEN MORCOS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MATTHEW R. PLAIN, ESQ. | Agent | ONE FINANCIAL PLAZA 18TH FLOOR, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| KATHLEEN COFFEY | PRESIDENT | 52 KAYLA RICCI WAY SAUNDERSTOWN, RI 02874 USA |
| Name | Role | Address |
|---|---|---|
| KERRI DAILEY | DIRECTOR | 6 ESQUIRE AVENUE WARWICK, RI 02889 USA |
| KIRSTEN YAGOOBIAN | DIRECTOR | 608 KETTLE POND DRIVE WAKEFIELD, RI 02879 USA |
| JOE GARCIA | DIRECTOR | 100 EAST GREENWICH AVENUE WEST WARWICK, RI 02893 USA |
| Number | Name | File Date |
|---|---|---|
| 202452953330 | Annual Report | 2024-04-29 |
| 202327963280 | Annual Report | 2023-02-09 |
| 202225171200 | Annual Report | 2022-12-13 |
| 202225170320 | Reinstatement | 2022-12-13 |
| 202224055060 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-10-13 |
| 202220472050 | Revocation Notice For Failure to File An Annual Report | 2022-06-28 |
| 202198736640 | Annual Report | 2021-06-28 |
| 202043242160 | Annual Report | 2020-06-24 |
| 202032994540 | Statement of Change of Registered/Resident Agent Office | 2020-01-24 |
| 201999794310 | Annual Report - Amended | 2019-06-27 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
