| Name: | Ocean State Behavioral Health LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 08 Jun 2020 (5 years ago) |
| Identification Number: | 001708532 |
| ZIP code: | 02919 |
| County: | Providence County |
| Principal Address: | 1524 ATWOOD AVE SUITE 244, JOHNSTON, RI, 02919, USA |
| Purpose: | PROVIDER OF BEHAVIORAL HEALTH SERVICES |
| Fictitious names: |
Ocean State Recovery Center (trading name, 2020-12-16 - ) |
NAICS
621420 Outpatient Mental Health and Substance Abuse CentersThis industry comprises establishments with medical staff primarily engaged in providing outpatient services related to the diagnosis and treatment of mental health disorders and alcohol and other substance abuse. These establishments generally treat patients who do not require inpatient treatment. They may provide a counseling staff and information regarding a wide range of mental health and substance abuse issues and/or refer patients to more extensive treatment programs, if necessary. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508462128 | 2020-12-09 | 2020-12-09 | 1524 ATWOOD AVE STE 244, JOHNSTON, RI, 029193228, US | 1524 ATWOOD AVE STE 244, JOHNSTON, RI, 029193228, US | |||||||||||||
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| Phone | +1 401-626-0169 |
Authorized person
| Name | CHRISTOPHER DORVAL |
| Role | PROVIDER |
| Phone | 4016260169 |
Taxonomy
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OCEAN STATE RECOVERY CENTER 401(K) PLAN | 2023 | 851328170 | 2024-05-24 | OCEAN STATE BEHAVIORAL HEALTH LLC. | 13 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-24 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 4016260169 |
| Plan sponsor’s address | 1524 ATWOOD AVENUE, SUITE 244, JOHNSTON, RI, 02919 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-12 |
| Name of individual signing | CHRIS DORVAL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 4016260169 |
| Plan sponsor’s address | 1524 ATWOOD AVENUE SUITE 244, JOHNSTON, RI, 02919 |
Signature of
| Role | Plan administrator |
| Date | 2022-04-04 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CHRIS DORVAL | Agent | 1524 ATWOOD AVE SUITE 244, JOHNSTON, RI, 02919, USA |
| Number | Name | File Date |
|---|---|---|
| 202444044840 | Annual Report | 2024-01-16 |
| 202326204690 | Annual Report | 2023-01-19 |
| 202208285450 | Annual Report | 2022-01-20 |
| 202198667430 | Annual Report | 2021-06-25 |
| 202198666370 | Statement of Change of Registered/Resident Agent Office | 2021-06-25 |
| 202080274360 | Fictitious Business Name Statement | 2020-12-16 |
| 202041639160 | Articles of Organization | 2020-06-08 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
