| Entity Name: | FORM HEALTH ASSOCIATES (MA), P.C. |
| Jurisdiction: | Connecticut |
| Legal type: | Stock |
| Citizenship: | Foreign |
| Status: | Active |
| Date Formed: | 20 Jan 2021 (Companies founded in January 2021) |
| Business ALEI: | 1374520 |
| Annual report due: | 20 Jan 2025 |
| NAICS code: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Business address: | 179 LINCOLN STREET #404, BOSTON, MA, 02111, United States |
| Mailing address: | 179 LINCOLN STREET #404, BOSTON, MA, United States, 02111 |
| Place of Formation: | MASSACHUSETTS |
| E-Mail: | cls-ctarmsevidence@wolterskluwer.com |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| NAM KIM M.D. | Officer | 179 LINCOLN STREET #404, BOSTON, MA, 02111, United States | 179 LINCOLN STREET #404, BOSTON, MA, 02111, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| NAM KIM M.D. | Director | 179 LINCOLN STREET #404, BOSTON, MA, 02111, United States | 179 LINCOLN STREET #404, BOSTON, MA, 02111, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012367511 | 2024-01-04 | No data | Annual Report | Annual Report | No data |
| BF-0011095815 | 2023-01-17 | No data | Annual Report | Annual Report | No data |
| BF-0010175360 | 2023-01-17 | No data | Annual Report | Annual Report | 2022 |
| 0007074597 | 2021-01-20 | 2021-01-20 | Business Registration | Certificate of Authority | No data |
Date of last update: 11 Nov 2024
Sources: Connecticut's Official State Website
