| Name: | PVD CARES WELLNESS CENTER LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 18 Nov 2019 (5 years ago) |
| Identification Number: | 001701991 |
| ZIP code: | 02860 |
| County: | Providence County |
| Principal Address: | 126 PROSPECT STREET SUITE 105, PAWTUCKET, RI, 02860, USA |
| Purpose: | PRIMARY CARE AND MENTAL HEALTH CLINIC |
NAICS
621330 Offices of Mental Health Practitioners (except Physicians)This industry comprises establishments of independent mental health practitioners (except physicians) primarily engaged in (1) the diagnosis and treatment of mental, emotional, and behavioral disorders and/or (2) the diagnosis and treatment of individual or group social dysfunction brought about by such causes as mental illness, alcohol and substance abuse, physical and emotional trauma, or stress. 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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063059244 | 2019-12-05 | 2021-06-29 | 126 PROSPECT ST, PAWTUCKET, RI, 028604476, US | 126 PROSPECT ST STE 105, PAWTUCKET, RI, 028604429, US | |||||||||||||||
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| Phone | +1 401-753-2526 |
| Fax | 4012354152 |
Authorized person
| Name | EFFIEN KING |
| Role | NURSE PRACTITIONER |
| Phone | 3237706210 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MILEN KING | Agent | 34 REDWOOD DRIVE, NORTH PROVIDENCE, RI, 02911, USA |
| Number | Name | File Date |
|---|---|---|
| 202450798230 | Miscellaneous Filing (Fee Applicable) | 2024-04-10 |
| 202450798140 | Annual Report | 2024-04-10 |
| 202340810620 | Annual Report | 2023-09-08 |
| 202340809660 | Annual Report | 2023-09-08 |
| 202340810260 | Annual Report | 2023-09-08 |
| 202340809200 | Reinstatement | 2023-09-08 |
| 202210452460 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-02-14 |
| 202106631070 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 201927615320 | Miscellaneous Filing (Fee Applicable) | 2019-11-18 |
| 201927605420 | Articles of Organization | 2019-11-18 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
