| Name: | BAXTER BEHAVIORAL HEALTH, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 20 Mar 2015 (10 years ago) |
| Identification Number: | 001095466 |
| ZIP code: | 02852 |
| County: | Washington County |
| Principal Address: | P.O. BOX 949, NORTH KINGSTOWN, RI, 02852, USA |
| Mailing Address: | PO BOX 949, NORTH KINGSTOWN, RI, 02852, USA |
| Purpose: | TO ENGAGE IN ANY LAWFUL BUSINESS |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972975845 | 2015-10-30 | 2024-06-05 | PO BOX 949, NORTH KINGSTOWN, RI, 028520610, US | 1130 TEN ROD RD STE D101, NORTH KINGSTOWN, RI, 028524161, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-267-4485 |
| Fax | 4012674534 |
Authorized person
| Name | RYAN PATRICK BAXTER |
| Role | OWNER |
| Phone | 4012674485 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | NPP37892 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1972975485 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| BRUCE A. WOLPERT, ESQ. | Agent | 235 PROMENADE STREET SUITE 475, PROVIDENCE, RI, 02908, USA |
| Number | Name | File Date |
|---|---|---|
| 202448561910 | Annual Report | 2024-03-12 |
| 202330765400 | Annual Report | 2023-03-11 |
| 202222500030 | Statement of Change of Registered/Resident Agent Office | 2022-08-26 |
| 202212469060 | Annual Report | 2022-03-07 |
| 202102206470 | Annual Report | 2021-09-27 |
| 202062951210 | Annual Report | 2020-10-06 |
| 201918755820 | Annual Report | 2019-09-09 |
| 201877718180 | Annual Report | 2018-09-17 |
| 201752191480 | Annual Report | 2017-10-23 |
| 201610227120 | Annual Report | 2016-10-11 |
Date of last update: 20 Oct 2024
Sources: Rhode Island Department of State
