Healthcare Provider Details

I. General information

NPI: 1841716230
Provider Name (Legal Business Name): RI ALTERNATIVE ACADEMY MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 DRAPER AVE
WARWICK RI
02889-5046
US

IV. Provider business mailing address

1041 TEN ROD RD STE B
NORTH KINGSTOWN RI
02852-4125
US

V. Phone/Fax

Practice location:
  • Phone: 401-773-7866
  • Fax: 401-633-7496
Mailing address:
  • Phone: 401-742-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. SHANE T MCCONNELL
Title or Position: SUPERINTENDENT/FOUNDER
Credential: M.ED
Phone: 401-742-1577