| 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 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 | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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
