| Name: | EMBRACE HEALING PSYCHIATRIC SERVICES, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 24 Jul 2014 (11 years ago) |
| Identification Number: | 000963986 |
| ZIP code: | 02906 |
| County: | Providence County |
| Principal Address: | 345 BLACKSTONE BOULEVARD BUTLER HOSPITAL, PROVIDENCE, RI, 02906, USA |
| Purpose: | PROVIDING MEDICAL SERVICES SPECIALIZING IN PSYCHIATRIC SERVICES |
NAICS
621111 Offices of Physicians (except Mental Health Specialists)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679977342 | 2014-10-09 | 2014-10-09 | 345 BLACKSTONE BLVD, PROVIDENCE, RI, 029064800, US | 345 BLACKSTONE BLVD, PROVIDENCE, RI, 029064800, US | |||||||||||||||||||||
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| Phone | +1 401-455-6357 |
| Fax | 4014556566 |
| Fax | 4014553566 |
Authorized person
| Name | DR. GHULAM MUSTAFA SURTI |
| Role | PRESIDENT |
| Phone | 4014556357 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | MD09937 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHN W. WOLFE, ESQ. | Agent | 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA |
| Number | Name | File Date |
|---|---|---|
| 202446792000 | Annual Report | 2024-02-19 |
| 202329497530 | Annual Report | 2023-02-28 |
| 202214432350 | Annual Report | 2022-04-11 |
| 202207784800 | Statement of Change of Registered/Resident Agent | 2022-01-10 |
| 202107122090 | Annual Report | 2021-12-15 |
| 202105820880 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202072427730 | Annual Report | 2020-11-06 |
| 201926405940 | Annual Report | 2019-10-31 |
| 201880079410 | Annual Report | 2018-10-24 |
| 201751617620 | Annual Report | 2017-10-13 |
Date of last update: 11 May 2025
Sources: Rhode Island Department of State
