| Name: | Michelle Crandall, PCNS, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 15 May 2014 (11 years ago) |
| Date of Dissolution: | 08 Jun 2016 (9 years ago) |
| Date of Status Change: | 08 Jun 2016 (9 years ago) |
| Identification Number: | 000936458 |
| ZIP code: | 02894 |
| County: | Washington County |
| Principal Address: | 35 DAWN LANE P.O. BOX 204, WOOD RIVER JUNCTION, RI, 02894, USA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376956342 | 2014-06-08 | 2014-06-08 | PO BOX 204, WOOD RIVER JUNCTION, RI, 028940204, US | 35 DAWN LN, WOOD RIVER JUNCTION, RI, 028941001, US | |||||||||||||||||
|
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| Phone | +1 401-364-0739 |
Authorized person
| Name | MICHELLE CRANDALL |
| Role | OWNER |
| Phone | 4013640739 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| License Number | PPNS00087 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MICHELLE CRANDALL, PCNS | Agent | 35 DAWN LANE, WOOD RIVER JUNCTION, RI, 02894, USA |
| Number | Name | File Date |
|---|---|---|
| 201600231670 | Revocation Certificate For Failure to File the Annual Report for the Year | 2016-06-08 |
| 201694219550 | Revocation Notice For Failure to File An Annual Report | 2016-03-14 |
| 201445384560 | Articles of Amendment | 2014-09-05 |
| 201439191400 | Articles of Organization | 2014-05-15 |
Date of last update: 19 Oct 2024
Sources: Rhode Island Department of State
