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REVERENT HEALTH NURSE PRACTITIONER IN PSYCHIATRY PLLC

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Company Details

Name: REVERENT HEALTH NURSE PRACTITIONER IN PSYCHIATRY PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 21 Jun 2024 (a year ago)
Entity Number: 7468770
ZIP code: 14228
County: Erie
Place of Formation: New York
Address: 3211 sweet home road, BUFFALO, NY, United States, 14228

DOS Process Agent

Name Role Address
the llc DOS Process Agent 3211 sweet home road, BUFFALO, NY, United States, 14228

National Provider Identifier

NPI Number:
1689480642
Certification Date:
2024-12-04

Authorized Person:

Name:
SANDRA BLESSING OKENGWU
Role:
PSYCHIATRIC NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
7162878297

Filings

Filing Number Date Filed Type Effective Date
241120002194 2024-06-21 ARTICLES OF ORGANIZATION 2024-06-21

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State