| Name: | Alternative Integrative Medicine, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 04 Nov 2019 (5 years ago) |
| Identification Number: | 001701570 |
| Principal Address: | 24 CORLISS STREET BOX # 41546, PROVIDENCE, RI, 02940, USA |
| Purpose: | OUTPATIENT CARE FACILITY |
| NAICS: | 621498 - All Other Outpatient Care Centers |
| Fictitious names: |
AIM Healthier Shop (trading name, 2020-04-01 - ) A.I.M. Health (trading name, 2020-02-13 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063034767 | 2020-05-15 | 2023-06-02 | 222 JEFFERSON BLVD STE 4, WARWICK, RI, 028883847, US | 222 JEFFERSON BLVD STE 4, WARWICK, RI, 028883847, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-423-4433 |
Authorized person
| Name | BRANDON NOWAK |
| Role | CEO |
| Phone | 4014234433 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 163WC0400X - Case Management Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 225700000X - Massage Therapist |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
Other Provider Identifiers
| Issuer | OACF LICENSE |
| Number | ACF01642 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JASON IRVING SIMMONS | Agent | 222 JEFFERSON BOULEVARD UNIT 4, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| BRANDON NOWAK | PRESIDENT | 24 CORLISS STREET BOX # 41546 PROVIDENCE, RI 02940 USA |
| Name | Role | Address |
|---|---|---|
| JASON SIMMONS | VICE PRESIDENT | 24 CORLISS STREET BOX # 41546 PROVIDENCE, RI 02940 USA |
| Number | Name | File Date |
|---|---|---|
| 202444072230 | Annual Report - Amended | 2024-01-16 |
| 202443832970 | Annual Report | 2024-01-09 |
| 202339305850 | Annual Report | 2023-07-10 |
| 202338207650 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202211652580 | Annual Report | 2022-02-25 |
| 202197316960 | Annual Report | 2021-06-01 |
| 202197010570 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202037058850 | Fictitious Business Name Statement | 2020-04-01 |
| 202033596400 | Fictitious Business Name Statement | 2020-02-13 |
| 202032777350 | Statement of Change of Registered/Resident Agent Office | 2020-01-22 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
