| 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) |
| 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: 19 Oct 2024
Sources: Rhode Island Department of State
