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Evidence Based Services LLC Connecticut Division

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Company Details

Entity Name: Evidence Based Services LLC Connecticut Division
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 26 Jul 2021
Date of dissolution: 14 Oct 2021
Business ALEI: 2312289
Business address: 222 Beaver Hill Rd, North Windham, CT, 06256-1236, United States
Mailing address: 222 Beaver Hill Rd, North Windham, CT, United States, 06256-1236
ZIP code: 06256
County: Windham
Place of Formation: CONNECTICUT
E-Mail: evidencebasedct@gmail.com

Industry & Business Activity

NAICS

621330 Offices of Mental Health Practitioners (except Physicians)

Officer

Name Role Business address Phone E-Mail Residence address
Erika Wenzel Officer 222 Beaver Hill Rd, North Windham, CT, 06256-1236, United States +1 860-234-2764 evidencebasedct@gmail.com 222 Beaver Hill Rd, North Windham, CT, 06256-1236, United States

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
Erika Wenzel Agent 222 Beaver Hill Rd, North Windham, CT, 06256-1236, United States 222 Beaver Hill Rd, North Windham, CT, 06256-1236, United States +1 860-234-2764 evidencebasedct@gmail.com 222 Beaver Hill Rd, North Windham, CT, 06256-1236, United States

National Provider Identifier

NPI Number:
1578134987
Certification Date:
2021-07-10

Authorized Person:

Name:
ERIKA WENZEL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0010130158 2021-10-14 2021-10-14 Dissolution Certificate of Dissolution -
BF-0010091403 2021-07-26 - Business Formation Certificate of Organization -

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Sources: Company Profile on Connecticut's Official State Website

* While we strive to keep this information correct and up-to-date, it is not the primary source, and the dataset source should always be referred to for definitive information