| Name: | CharterCARE Our Lady of Fatima Hospital |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 05 Dec 2022 (2 years ago) |
| Identification Number: | 001749428 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | THE CORPORATION IS ORGANIZED AND AT ALL TIMES SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, SCIENTIFIC OR EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) |
| NAICS: | 622110 - General Medical and Surgical Hospitals |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467281329 | 2024-07-30 | 2024-07-30 | 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045113, US | 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045113, US | |||||||||||||||
|
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| Phone | +1 401-456-3000 |
| Fax | 4014563028 |
Authorized person
| Name | JEFFREY LIEBMAN |
| Role | CEO |
| Phone | 4014562001 |
Taxonomy
| Taxonomy Code | 273R00000X - Psychiatric Hospital Unit |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MCLAUGHLINQUINN LLC | Agent | 148 WEST RIVER STREET SUITE 1E, PROVIDENCE, RI, 02904, USA |
| Name | Role | Address |
|---|---|---|
| GREG GROVE | TREASURER | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| Name | Role | Address |
|---|---|---|
| GREG GROVE | SECRETARY | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| Name | Role | Address |
|---|---|---|
| GREG GROVE | VICE PRESIDENT | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| Name | Role | Address |
|---|---|---|
| BEN MINGLE | CHAIR | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| Name | Role | Address |
|---|---|---|
| GREG GROVE | DIRECTOR | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| JEFF LIEBMAN | DIRECTOR | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| BEN MINGLE | DIRECTOR | 3060 PEACHTREE RD NW, STE. 1030 ATLANTA, GA 30305 USA |
| Number | Name | File Date |
|---|---|---|
| 202459112280 | Statement of Change of Registered/Resident Agent | 2024-08-29 |
| 202451864880 | Annual Report | 2024-04-22 |
| 202332602000 | Annual Report | 2023-04-10 |
| 202225043480 | Articles of Incorporation | 2022-12-05 |
Date of last update: 29 Oct 2024
Sources: Rhode Island Department of State
