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AGING WITH VITALITY- AWV LLC

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Company Details

Name: AGING WITH VITALITY- AWV LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 20 Oct 2024 (10 months ago)
Entity Number: 7445673
ZIP code: 12564
County: Dutchess
Place of Formation: New York
Address: 19 circle drive, Pawling, NY, United States, 12564

DOS Process Agent

Name Role Address
Nicole Arvidson DOS Process Agent 19 circle drive, Pawling, NY, United States, 12564

National Provider Identifier

NPI Number:
1114726635
Certification Date:
2025-03-08

Authorized Person:

Name:
NICOLE SASHANNA ARVIDSON
Role:
NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
363LA2100X - Acute Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LG0600X - Gerontology Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LP2300X - Primary Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LA2200X - Adult Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
241020000085 2024-10-20 ARTICLES OF ORGANIZATION 2024-10-20

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State