| Name: | Baker Wellness LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 20 Mar 2022 (3 years ago) |
| Date of Dissolution: | 11 Sep 2023 (a year ago) |
| Date of Status Change: | 11 Sep 2023 (a year ago) |
| Identification Number: | 001737765 |
| ZIP code: | 02852 |
| County: | Washington County |
| Principal Address: | 1130 TEN ROD ROAD SUITE D307D, NORTH KINGSTOWN, RI, 02852, USA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558011627 | 2022-03-24 | 2022-03-24 | 95 MULBERRY DR APT 410, NORTH KINGSTOWN, RI, 028524592, US | 1130 TEN ROD RD STE D307D, NORTH KINGSTOWN, RI, 028524180, US | |||||||||||||||||
|
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| Phone | +1 401-601-5080 |
Authorized person
| Name | CHRISTOPHER BAKER |
| Role | OWNER |
| Phone | 4016015080 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1700309754 |
| Name | Role | Address |
|---|---|---|
| CHRISTOPHER BAKER | Agent | 95 MULBERRY DRIVE APT. # 410, NORTH KINGSTOWN, RI, 02852, USA |
| Number | Name | File Date |
|---|---|---|
| 202341198790 | Revocation Certificate For Failure to File the Annual Report for the Year | 2023-09-11 |
| 202337401860 | Revocation Notice For Failure to File An Annual Report | 2023-06-16 |
| 202213122540 | Articles of Organization | 2022-03-20 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
