| Name: | Affect Provider Group, P.S.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 26 Dec 2023 (a year ago) |
| Date of Dissolution: | 17 Sep 2024 (7 months ago) |
| Date of Status Change: | 17 Sep 2024 (7 months ago) |
| Branch of: | Affect Provider Group, P.S.C., KENTUCKY (Company Number 1181463) |
| Identification Number: | 001766936 |
| Place of Formation: | KENTUCKY |
| Principal Address: | 116 NORTH THIRD STREET SUITE 3, DANVILLE, KY, 40422, USA |
| Purpose: | HEALTHCARE PROVIDER OFFERING DIGITAL SUBSTANCE USE DISORDER TREATMENT |
| Fictitious names: |
Affect Provider Group, P.C. (trading name, 2023-12-26 - ) |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| DOUGLAS ELWOOD MD | PRESIDENT | 220 5TH AVENUE, 17TH FLOOR NEW YORK, NY 10001 |
| Number | Name | File Date |
|---|---|---|
| 202459648860 | Revocation Certificate For Failure to File the Annual Report for the Year | 2024-09-17 |
| 202457378200 | Revocation Notice For Failure to File An Annual Report | 2024-06-25 |
| 202343557540 | Application for Certificate of Authority | 2023-12-26 |
| 202343557720 | Fictitious Business Name Statement | 2023-12-26 |
Date of last update: 29 Oct 2024
Sources: Rhode Island Department of State
