| 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 |
| Fictitious names: |
AIM Healthier Shop (trading name, 2020-04-01 - ) A.I.M. Health (trading name, 2020-02-13 - ) |
NAICS
621498 All Other Outpatient Care CentersThis U.S. industry comprises establishments with medical staff primarily engaged in providing general or specialized outpatient care (except family planning centers, outpatient mental health and substance abuse centers, HMO medical centers, kidney dialysis centers, and freestanding ambulatory surgical and emergency centers). Centers or clinics of health practitioners with different degrees from more than one industry practicing within the same establishment (i.e., Doctor of Medicine and Doctor of Dental Medicine) are included in this industry. Learn more at the U.S. Census Bureau
| 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9211278601 | 2021-03-25 | 0165 | PPP | 222 Jefferson Blvd Ste 4, Warwick, RI, 02888-3847 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
