| 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 SpecialistsThis U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of psychiatry or psychoanalysis. 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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |||||||||||||||
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| 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
