| 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) |
| 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
