Provider Demographics
NPI:1841716230
Name:RI ALTERNATIVE ACADEMY MANAGEMENT, LLC
Entity type:Organization
Organization Name:RI ALTERNATIVE ACADEMY MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT/FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:401-742-1577
Mailing Address - Street 1:1041 TEN ROD ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852
Mailing Address - Country:US
Mailing Address - Phone:401-742-2300
Mailing Address - Fax:
Practice Address - Street 1:249 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:401-742-1577
Practice Address - Fax:401-667-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)