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POCATELLO CHILDREN AND ADOLESCENT CLINIC, P.A.

POCATELLO CHILDREN AND ADOLESCENT CLINIC, P.A.

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Company Details

Name:	POCATELLO CHILDREN AND ADOLESCENT CLINIC, P.A.
Jurisdiction:	Idaho
Legal type:	Professional Service Corporation (D)
Status:	Active-Good Standing
Date of registration:	28 Dec 1985 (40 years ago)
Financial Date End:	31 Dec 2025
Entity Number:	250670
Place of Formation:	IDAHO
File Number:	250670
ZIP code:	83201
County:	Bannock County
Mailing Address:	JESSICA PERRY 1151 HOSPITAL WAY BLDG F POCATELLO, ID 83201-5091

President

Name	Role	Address	Appointed On
Matthew Murdoch	President	1151 HOSPITAL WAY, BLDG F, 83201, ID 83201	2020-11-05

Director

Name	Role	Address	Appointed On	Resigned On
Gentry Yost	Director	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06
Don McInturff	Director	1151 HOSPITAL WAY, BLDG F, 83201, ID 83201	2023-11-06	2023-11-06
Laura Duty	Director	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06
Shaun Summerill	Director	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06
Cindy Parsons	Director	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06
Matthew Stelzer	Director	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06
David Larsen	Director	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06

Secretary

Name	Role	Address	Appointed On	Resigned On
David Denton	Secretary	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06

Vice President

Name	Role	Address	Appointed On	Resigned On
Brian Fulks	Vice President	1151 HOSPITAL WAY, BLDG F, POCATELLO, ID 83201	2023-11-06	2023-11-06

Agent

Name	Role	Address
JESSICA PERRY	Agent	1151 HOSPITAL WAY, BUILDING F, POCATELLO, ID 83201

Unique Entity ID

Unique Entity ID:

G2M4K8PBEHC7

CAGE Code:

95DW1

UEI Expiration Date:

2026-02-04

Business Information

Doing Business As:

POCATELLO CHILDREN'S CLINIC

Activation Date:

2025-02-06

Initial Registration Date:

2021-09-03

Form 5500 Series

Employer Identification Number (EIN):

820401908

Plan Year:

2023

Number Of Participants:

51

Sponsors Telephone Number:

2082321443

File:

Plan Year:

2022

Number Of Participants:

51

Sponsors Telephone Number:

2082321443

File:

Plan Year:

2021

Number Of Participants:

53

Sponsors Telephone Number:

2082321443

File:

Plan Year:

2020

Number Of Participants:

54

Sponsors Telephone Number:

2082321443

File:

Plan Year:

2019

Number Of Participants:

48

Sponsors Telephone Number:

2082321443

File:

Filing

Filing Name	Filing Number	Filing date
Annual Report	0005969492	2024-11-06
Annual Report	0005466246	2023-11-06
Annual Report	0004970051	2022-11-03
Annual Report	0004478037	2021-11-03
Annual Report	0004060110	2020-11-05

USAspending Awards / Financial Assistance

Date:

2020-04-15

Link:

View on USAspending

Awarding Agency Name:

Small Business Administration

Transaction Description:

TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.

Obligated Amount:

0.00

Face Value Of Loan:

-8800.00

Total Face Value Of Loan:

514000.00

OSHA's Inspections within Industry

Inspection Summary

Date:

1997-07-15

Type:

Complaint

Address:

500 S. 11TH AVENUE, POCATELLO, ID, 83205

Safety Health:

Health

Scope:

Complete

Inspection Link:

View Inspection data on OSHA website

Paycheck Protection Program

Jobs Reported:

42

Initial Approval Amount:

$522,800

Date Approved:

2020-04-07

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$514,000

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$517,731.78

Servicing Lender:

Bank of Idaho

Use of Proceeds:

Payroll: $514,000

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Date of last update: 18 Jul 2025

Sources: Idaho Secretary of State