| Name: | Blossom Health, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 22 Jul 2020 (5 years ago) |
| Identification Number: | 001710457 |
| ZIP code: | 02893 |
| County: | Kent County |
| Principal Address: | 1300 DIVISION ROAD SUITE 301, WEST WARWICK, RI, 02893, USA |
| Purpose: | BLOSSOM HEALTH IS A TELEPSYCHIATRY PRACTICE |
| NAICS: | 621112 - Offices of Physicians, Mental Health Specialists |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316692320 | 2022-02-17 | 2022-02-17 | 1300 DIVISION ROAD, SUITE 301, WEST WARWICK, RI, 02893, US | 1300 DIVISION ROAD, SUITE 301, WEST WARWICK, RI, 02893, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 401-586-6877 |
| Fax | 8337920895 |
Authorized person
| Name | DR. DANA SIPERSTEIN |
| Role | OWNER |
| Phone | 4015866877 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DANA SIPERSTEIN | Agent | 1300 DIVISION ROAD SUITE 301, WEST WARWICK, RI, 02893, USA |
| Name | Role | Address |
|---|---|---|
| DANA SIPERSTEIN, M.D. | Manager | 1300 DIVISION ROAD, SUITE 301 WEST WARWICK, RI 02893 USA |
| Number | Name | File Date |
|---|---|---|
| 202460263960 | Statement of Change of Registered/Resident Agent | 2024-09-23 |
| 202343190260 | Annual Report | 2023-12-05 |
| 202325625180 | Annual Report | 2023-01-03 |
| 202208822060 | Annual Report | 2022-01-28 |
| 202208821180 | Annual Report | 2022-01-28 |
| 202106127780 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202045990870 | Articles of Organization | 2020-07-22 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
