| Name: | Balsam Lotus Healing & Wellness, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 01 Nov 2022 (2 years ago) |
| Identification Number: | 001748028 |
| ZIP code: | 02920 |
| County: | Providence County |
| Principal Address: | 16 PEEP TOAD COURT, SEEKONK, MA, 02771, USA |
| Mailing Address: | 63 SOCKANOSSET CROSS ROAD, CRANSTON, RI, 02920, USA |
| Purpose: | MENTAL HEALTH AND WELLNESS |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104537646 | 2022-12-06 | 2022-12-06 | 63 SOCKANOSSET CROSS RD STE 63C, CRANSTON, RI, 029205557, US | 63 SOCKANOSSET CROSS RD STE 63C, CRANSTON, RI, 029205557, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 401-541-5989 |
Authorized person
| Name | ALYSSA GOULET-ALMEIDA |
| Role | OWNER, FOUNDER, THERAPIST |
| Phone | 4015415989 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 854003564 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JEREMIAH C. LYNCH, III | Agent | 97 JOHN CLARKE ROAD, MIDDLETOWN, RI, 02842, USA |
| Number | Name | File Date |
|---|---|---|
| 202445396560 | Annual Report | 2024-02-02 |
| 202328516160 | Annual Report | 2023-02-16 |
| 202224447450 | Articles of Organization | 2022-11-01 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
