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  5. Community Provider Network of Rhode Island

Community Provider Network of Rhode Island

Company Details

Name: Community Provider Network of Rhode Island
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 29 Jun 2004 (21 years ago)
Identification Number: 000141129
ZIP code: 02852
County: Washington County
Principal Address: 1130 TEN ROD ROAD SUITE F101, NORTH KINGSTOWN, RI, 02852, USA
Purpose: TO ORGANIZE INFORMATION AND RESOURCES AND STRENGTHEN COMMUNICATION AND KNOWLEDGE SHARING AMONG THE MEMBER AGENCIES ON ISSUES OF COMMON INTERET AND CONCERN
NAICS: 624120 - Services for the Elderly and Persons with Disabilities
Fictitious names: PRB (trading name, 2004-06-29 - )
OSARR (trading name, 2004-06-29 - )
Ocean State Association of Residential Resources (trading name, 2004-06-29 - )
Provider Resources & Benefits (trading name, 2004-06-29 - )
Historical names: OSARR/PRB

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN FOR EMPLOYEES OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2023 050417016 2024-07-29 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2024-07-29
Name of individual signing TINA SPEARS
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2021 050417016 2022-10-06 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2022-10-06
Name of individual signing TINA SPEARS
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2020 050417016 2021-07-16 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2021-07-16
Name of individual signing TINA SPEARS
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2019 050417016 2020-07-13 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2020-07-13
Name of individual signing TINA SPEARS
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2018 050417016 2019-08-28 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2019-08-28
Name of individual signing TINA SPEARS
Valid signature Filed with authorized/valid electronic signature
403 B THRIFT PLAN OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2017 050417016 2018-06-15 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2018-06-15
Name of individual signing DONNA MARTIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-15
Name of individual signing DONNA MARTIN
Valid signature Filed with authorized/valid electronic signature
403 B THRIFT PLAN OF COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 2016 050417016 2017-09-05 COMMUNITY PROVIDER NETWORK OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 624100
Sponsor’s telephone number 4017737771
Plan sponsor’s address 110 JEFFERSON BLVD STE A, WARWICK, RI, 028883854

Signature of
Role Plan administrator
Date 2017-09-05
Name of individual signing DONNA MARTIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-05
Name of individual signing DONNA MARTIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
TINA SPEARS Agent 1130 TEN ROD ROAD SUITE F101, NORTH KINGSTOWN, RI, 02852, USA

TREASURER

Name Role Address
CASEY GARTLAND TREASURER 158 KNIGHT STREET WARWICK, RI 02886 USA

PRESIDENT

Name Role Address
LIZ WIEDENHOFER PRESIDENT 490 METACOM AVENUE, UNIT 9 BRISTOL, RI 02809 USA

SECRETARY

Name Role Address
CARRIE MIRANDA SECRETARY 438 E MAIN ROAD MIDDLETOWN, RI 02842 USA

VICE PRESIDENT

Name Role Address
MICHAEL PEARIS VICE PRESIDENT 610 MANTON AVENUE PROVIDENCE, RI 02909 USA

DIRECTOR

Name Role Address
TINA SPEARS DIRECTOR 1130 TEN ROD ROAD NORTH KINGSTOWN, RI 02852 USA
MARISSA RUFF DIRECTOR 1 ALBION ROAD, SUITE 201 LINCOLN, RI 02865 USA
RAY MEMERY DIRECTOR 33 COLLEGE HILL ROAD WARWICK, RI 02886 USA

Events

Type Date Old Value New Value
Name Change 2005-04-27 OSARR/PRB Community Provider Network of Rhode Island

Filings

Number Name File Date
202444926470 Annual Report 2024-01-29
202331069840 Annual Report 2023-03-20
202330850980 Statement of Change of Registered/Resident Agent Office 2023-03-15
202330781040 Statement of Change of Registered/Resident Agent Office 2023-03-14
202211716020 Annual Report 2022-02-23
202101837080 Annual Report 2021-09-21
202101835590 Statement of Change of Registered/Resident Agent Office 2021-09-21
202101834610 Reinstatement 2021-09-21
202100478400 Revocation Certificate For Failure to Maintain a Registered Office 2021-08-30
202198841100 Revocation Notice For Failure to Maintain a Registered Office 2021-06-30

Related by officers

CASEY GARTLAND

WEST BAY RESIDENTIAL SERVICES, INC.

CARRIE MIRANDA

CPNRI Benefit Fund Inc.

MICHAEL PEARIS

JDC CORPORATION Rhode Island Coalition For Children & Families, Inc. Rhode Island Coalition For Children & Families Education Fund, Inc.

MARISSA RUFF

YWCA RHODE ISLAND

Related by address

No related companies by address

Date of last update: 09 Oct 2024

Sources: Rhode Island Department of State

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