| Name: | Complete Health Primary Care LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Jun 2021 (4 years ago) |
| Identification Number: | 001725437 |
| ZIP code: | 02920 |
| County: | Providence County |
| Principal Address: | 215 TOLLGATE RD STE 309, WARWICK, RI, 02866, USA |
| Mailing Address: | 1150 RESERVOIR AVE STE 203, CRANSTON, RI, 02920, USA |
| Purpose: | PRIMARY CARE SERVICES |
| NAICS: | 621112 - Offices of Physicians, Mental Health Specialists |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316516768 | 2021-06-21 | 2021-06-21 | 1150 RESERVOIR AVE STE 203, CRANSTON, RI, 029206043, US | 215 TOLL GATE RD STE 309, WARWICK, RI, 028864463, US | |||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-259-0340 |
| Fax | 4012138538 |
Authorized person
| Name | JEREMY HILLIS |
| Role | OWNER |
| Phone | 4012590340 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 104100000X - Social Worker |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JEREMY HILLIS | Agent | 215 TOLL GATE ROAD SUITE 209, WARWICK, RI, 02886, USA |
| Number | Name | File Date |
|---|---|---|
| 202458787290 | Annual Report | 2024-08-14 |
| 202456508680 | Revocation Notice For Failure to File An Annual Report | 2024-06-18 |
| 202338621140 | Annual Report | 2023-06-23 |
| 202337413520 | Revocation Notice For Failure to File An Annual Report | 2023-06-16 |
| 202209742420 | Certificate of Correction | 2022-02-08 |
| 202209104110 | Annual Report | 2022-02-01 |
| 202198196660 | Articles of Organization | 2021-06-14 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
