| Name: | Koann Therapeutic Services Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 21 Jul 2021 (4 years ago) |
| Identification Number: | 001727176 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 845 NORTH MAIN STREET L1A, PROVIDENCE, RI, 02904, USA |
| Purpose: | PSYCHIATRY AND MENTAL HEALTH SERVICES |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| Fictitious names: |
Revive Therapeutic Services (trading name, 2021-08-11 - ) |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | Koann Therapeutic Services Inc., KENTUCKY | 1304640 | KENTUCKY |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639843303 | 2021-08-05 | 2024-10-30 | PO BOX 3085, PAWTUCKET, RI, 028610585, US | 845 N MAIN ST, PROVIDENCE, RI, 029045700, US | |||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-648-7172 |
| Fax | 4016480161 |
Authorized person
| Name | AKOS ANTWI |
| Role | PROVIDER/CEO |
| Phone | 4016487172 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WP0807X - Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WP0809X - Adult Psychiatric/Mental Health Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent | 222 JEFFERSON BLVD. SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| AKOS ANTWI | PRESIDENT | 845 NORTH MAIN STREET, L1A PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| ABBY ANTWI | VICE PRESIDENT | 845 NORTH MAIN STREET, L1A PROVIDENCE, RI 02904 USA |
| Number | Name | File Date |
|---|---|---|
| 202446915120 | Annual Report | 2024-02-20 |
| 202332306250 | Annual Report | 2023-04-03 |
| 202326295850 | Annual Report | 2023-01-20 |
| 202221971020 | Annual Report | 2022-08-05 |
| 202220312310 | Revocation Notice For Failure to File An Annual Report | 2022-06-27 |
| 202100100400 | Fictitious Business Name Statement | 2021-08-11 |
| 202199455810 | Articles of Incorporation | 2021-07-21 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
