| Name: | MAP Behavioral Health Group, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 01 Apr 2022 (3 years ago) |
| Identification Number: | 001738321 |
| ZIP code: | 02907 |
| County: | Providence County |
| Principal Address: | 66 BURNETT STREET, PROVIDENCE, RI, 02907, USA |
| Purpose: | WE PROVIDE PSYCHIATRIC AND MENTAL HEALTH SERVICES. |
| NAICS: | 813920 - Professional Organizations |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992448534 | 2022-04-20 | 2022-04-20 | 343 ELMWOOD AVE, PROVIDENCE, RI, 029071546, US | 343 ELMWOOD AVE, PROVIDENCE, RI, 029071546, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-999-7010 |
Authorized person
| Name | LIONEL H. FERNANDEZ |
| Role | CEO/EXECUTIVE DIRECTOR |
| Phone | 4019997010 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| LIONEL H FERNANDEZ | Agent | 66 BURNETT ST, PROVIDENCE, RI, 02907, USA |
| Name | Role | Address |
|---|---|---|
| LIONEL H FERNANDEZ | MANAGER | 66 BURNETT ST PROVIDENCE, RI 02907 UNI |
| Number | Name | File Date |
|---|---|---|
| 202445868940 | Annual Report | 2024-02-07 |
| 202338764270 | Annual Report | 2023-06-27 |
| 202337488230 | Revocation Notice For Failure to File An Annual Report | 2023-06-16 |
| 202213814300 | Articles of Organization | 2022-04-01 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
