| Name: | Providence Wellness, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 06 Aug 2021 (4 years ago) |
| Date of Dissolution: | 11 Sep 2023 (a year ago) |
| Date of Status Change: | 11 Sep 2023 (a year ago) |
| Identification Number: | 001727827 |
| ZIP code: | 02907 |
| County: | Providence County |
| Principal Address: | 669 PUBLIC STREET, PROVIDENCE, RI, 02907, USA |
| Purpose: | OUTPATIENT MENTAL HEALTH TREATMENT |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659046936 | 2021-08-10 | 2021-08-10 | 669 PUBLIC ST, PROVIDENCE, RI, 029071640, US | 669 PUBLIC ST, PROVIDENCE, RI, 029071640, US | |||||||||||||
|
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| Phone | +1 401-585-3729 |
Authorized person
| Name | ALEXANDER KAROFF HUNGER |
| Role | LEAD CLINICIAN |
| Phone | 4015853729 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ALEXANDER KAROFF-HUNGER | Agent | 669 PUBLIC STREET, PROVIDENCE, RI, 02907, USA |
| Number | Name | File Date |
|---|---|---|
| 202341086970 | Revocation Certificate For Failure to File the Annual Report for the Year | 2023-09-11 |
| 202337375440 | Revocation Notice For Failure to File An Annual Report | 2023-06-16 |
| 202220914190 | Annual Report | 2022-07-11 |
| 202219285230 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202100019360 | Articles of Organization | 2021-08-06 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
