| Name: | PROSPECT CHARTERCARE SJHSRI, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 21 Aug 2013 (11 years ago) |
| Identification Number: | 000823569 |
| Principal Address: | 3824 HUGHES AVE., CULVER CITY, CA, 90232, USA |
| Purpose: | HEALTHCARE |
| NAICS: | 621610 - Home Health Care Services |
| Fictitious names: |
St. Joseph School of Nursing (trading name, 2014-07-21 - ) Our Lady of Fatima Hospital (trading name, 2014-03-25 - ) Fatima Hospital (trading name, 2014-03-25 - ) Fatima Hospital Radiology (trading name, 2014-03-25 - ) Fatima Hospital Out Patient Rehabilitation (trading name, 2014-03-25 - ) Fatima Hospital Rehabilitation Group (trading name, 2014-03-25 - ) Fatima Hospital Psychiatric/Social Services Group (trading name, 2014-03-25 - ) Southern New England Rehabilitation Center (trading name, 2014-03-25 - ) St. Joseph Dental Associates (trading name, 2014-03-25 - ) St. Joseph APC/Walk-In Group (trading name, 2014-03-25 - ) St. Joseph OB/GYN Group (trading name, 2014-03-25 - ) St. Joseph Pediatric Group (trading name, 2014-03-25 - ) St. Joseph Health Center (trading name, 2014-03-25 - ) Fatima Hospital Breast Health Group (trading name, 2014-03-25 - ) Fatima Hospital Wound Care Group (trading name, 2014-03-25 - ) Fatima Hospital Cardiology Group (trading name, 2014-03-25 - ) |
| Historical names: |
Prospect CharterCare SJHRSI, LLC |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821656034 | 2019-06-03 | 2021-01-15 | 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045113, US | 200 HIGH SERVICE AVE, N PROVIDENCE, RI, 029045113, US | |||||||||||||
|
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| Phone | +1 310-943-4500 |
Authorized person
| Name | ROBERT JON ELDERS |
| Role | SECRETARY |
| Phone | 7147881249 |
Taxonomy
| Taxonomy Code | 207RA0401X - Addiction Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2013-08-22 | Prospect CharterCare SJHRSI, LLC | PROSPECT CHARTERCARE SJHSRI, LLC |
| Number | Name | File Date |
|---|---|---|
| 202450553910 | Annual Report | 2024-04-09 |
| 202333381670 | Annual Report | 2023-04-20 |
| 202214691180 | Annual Report | 2022-04-14 |
| 202102308660 | Annual Report | 2021-09-29 |
| 202056092110 | Annual Report | 2020-09-18 |
| 201922791380 | Annual Report | 2019-10-04 |
| 201877878730 | Annual Report | 2018-09-20 |
| 201750285280 | Annual Report | 2017-09-22 |
| 201628547740 | Annual Report - Amended | 2016-12-05 |
| 201609402620 | Annual Report | 2016-09-26 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
