Name: | PACE Organization of Rhode Island |
Jurisdiction: | Rhode Island |
Entity type: | Domestic Non-Profit Corporation |
Status: | Activ |
Date of Organization in Rhode Island: | 27 Aug 2004 (20 years ago) |
Identification Number: | 000142328 |
ZIP code: | 02915 |
County: | Providence County |
Principal Address: | 10 TRIPPS LANE, RIVERSIDE, RI, 02915, USA |
Purpose: | TO PROVIDE CARE AND SERVICES TO THE ELDERLY |
NAICS: | 624120 - Services for the Elderly and Persons with Disabilities |
Fictitious names: |
Savory Fare (trading name, 2023-04-26 - 2023-05-02) PACE-RI (trading name, 2022-06-01 - ) Adult Day Center of Westerly (trading name, 2013-07-01 - ) Pace Organization of Rhode Island (trading name, 2005-04-13 - ) |
Historical names: |
CareLink Pace Organization Pace Organization of Rhode Island |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1083690044 | 2005-12-21 | 2024-07-09 | 10 TRIPPS LANE, RIVERSIDE, RI, 02915, US | 10 TRIPPS LANE, RIVERSIDE, RI, 02915, US | |||||||||||||||||||||||||||||||
|
Phone | +1 401-654-4789 |
Fax | 4016544660 |
Authorized person
Name | CRAIG MCANAUGH |
Role | CFO |
Phone | 4014341400 |
Taxonomy
Taxonomy Code | 251E00000X - Home Health Agency |
Is Primary | No |
Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
Is Primary | No |
Taxonomy Code | 302F00000X - Exclusive Provider Organization |
License Number | 19 |
State | RI |
Is Primary | Yes |
Other Provider Identifiers
Issuer | PACE DHS CONTRACT # |
Number | H4105 |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PACE ORGANIZATION OF RI 403(B) PLAN | 2023 | 300297335 | 2024-05-17 | PACE ORGANIZATION OF RHODE ISLAND | 174 | |||||||||||||||||||||||||||||||||
|
Role | Plan administrator |
Date | 2024-05-17 |
Name of individual signing | CRAIG MCANAUGH |
Valid signature | Filed with authorized/valid electronic signature |
Role | Employer/plan sponsor |
Date | 2024-05-17 |
Name of individual signing | CRAIG MCANAUGH |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 501 |
Effective date of plan | 2016-01-01 |
Business code | 624100 |
Sponsor’s telephone number | 4014906566 |
Plan sponsor’s mailing address | 225 CHAPMAN ST, PROVIDENCE, RI, 02905 |
Plan sponsor’s address | 225 CHAPMAN ST, PROVIDENCE, RI, 02905 |
Number of participants as of the end of the plan year
Active participants | 172 |
Signature of
Role | Plan administrator |
Date | 2018-07-30 |
Name of individual signing | LYNDA GILBERT |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role | Address |
---|---|---|
JOAN KWIATKOWSKI | Agent | 10 TRIPPS LANE, RIVERSIDE, RI, 02915, USA |
Name | Role | Address |
---|---|---|
JAYNE PAWASAUSKAS | DIRECTOR | 65 PARTRIDGE RUN . EAST GREENWICH, RI 02818 USA |
MITCHELL WICE | DIRECTOR | 128 DORSET ROAD WABAN , MA 02468 USA |
ELLEN MCCREEDY | DIRECTOR | 19 TARIS STREET PAWTUCKET, RI 02860 USA |
MARIE GANIM | DIRECTOR | 14 MITRIS BLVD LINCOLN, RI 02865 USA |
YASIN ABUL | DIRECTOR | 12 TOWNSEND ST BARRINGTON, RI 02806 USA |
ELLEN MCGOUGH | DIRECTOR | 25 W INDEPENDENCE WAY KINGSTON, RI 02881 USA |
MEGAN HERNE | DIRECTOR | 35 MADISON ST. WARWICK , RI 02888 USA |
CANDIDUS NWAKASI | DIRECTOR | 25 PAPER CHASE SOUTH WINDSOR, CT 06074 USA |
EDWARD DAREZZO | DIRECTOR | 72 ASHBURTON DRIVE CRANSTON, RI 02921 USA |
WHITNEY MILLS | DIRECTOR | 1402 PINEWOOD DRIVE SMITHFIELD, RI 02917 USA |
Name | Role | Address |
---|---|---|
DAVID DEJESUS | SECRETARY OF CLERK | 222 EDMOUND DR. NORTH KINGSTOWN, RI 02852 USA |
Name | Role | Address |
---|---|---|
KIM DENNY | TREASURER | 4 ST. MICHAELS CT. RUMFORD , RI 02916 USA |
Name | Role | Address |
---|---|---|
DALISSA KELLY | VICE PRESIDENT | 51 WILLOWTREE LANE MIDDLEBORO, MA 02346 USA |
Name | Role | Address |
---|---|---|
DANIELLE KOPF | PRESIDENT | 3 LAKESIDE DRIVE NARRAGANSETT, RI 02882 USA |
Type | Date | Old Value | New Value |
---|---|---|---|
Name Change | 2017-01-18 | Pace Organization of Rhode Island | PACE Organization of Rhode Island |
Name Change | 2017-01-17 | CareLink Pace Organization | Pace Organization of Rhode Island |
Merged | 2013-07-01 | Adult Day Center of Westerly Inc. on | PACE Organization of Rhode Island |
Number | Name | File Date |
---|---|---|
202445532760 | Annual Report | 2024-02-05 |
202335141010 | Statement of Abandonment of Use of Fictitious Business Name | 2023-05-02 |
202334102760 | Fictitious Business Name Statement | 2023-04-26 |
202327080590 | Annual Report | 2023-02-01 |
202218070710 | Fictitious Business Name Statement | 2022-06-01 |
202213295460 | Annual Report | 2022-03-23 |
202107282910 | Statement of Change of Registered/Resident Agent Office | 2021-12-20 |
202198071480 | Annual Report | 2021-06-09 |
202043212190 | Annual Report | 2020-06-24 |
201993872870 | Annual Report | 2019-05-22 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State