| Entity Name: | ReVive S.O.U.L. Medicine, PLLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 24 Feb 2023 |
| Business ALEI: | 2730712 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Business address: | 109 Bridge Street #121, Groton, CT, 06340, United States |
| Mailing address: | 109 Bridge Street #121, Groton, CT, United States, 06340 |
| ZIP code: | 06340 |
| County: | New London |
| Place of Formation: | CONNECTICUT |
| E-Mail: | revivesoulmedicine@gmail.com |
| Name | Role |
|---|---|
| BLOCK, JANNEY & SISLEY, LLC | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| YARDLEY BRICE, DO | Officer | 109 Bridge Street #121, Groton, CT, 06340, United States | 180 Briar Hill Rd, Groton, CT, 06340-2652, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012344675 | 2024-03-29 | No data | Annual Report | Annual Report | No data |
| BF-0011712213 | 2023-02-24 | No data | Business Formation | Certificate of Organization | No data |
Date of last update: 20 Jan 2025
Sources: Connecticut's Official State Website
