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Trivium Life Services Mountain West, LLC

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Company Details

Name: Trivium Life Services Mountain West, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 24 Feb 2010 (15 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 282430
Place of Formation: IDAHO
File Number: 282430
Principal Address: SUITE 190 12553 W. EXPLORER DRIVE BOISE, ID 83713
Mailing Address: NATE WATSON, LEGAL COUNSEL SUITE 190 12553 W. EXPLORER DRIVE BOISE, ID 83713

Agent

Name Role Address
COGENCY GLOBAL INC. Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

Manager

Name Role Address Appointed On Resigned On
DARIAN M ZIMA Manager 8950 W EMERALD ST, BOISE, ID 83704-8296 2023-02-14 No data
Amy K Jeppesen Manager 8950 W EMERALD ST, BOISE, ID 83704 2021-02-03 2023-02-14
Brent Dillinger Manager 4201 RIVERS EDGE PKWY, COUNCIL BLUFFS, IA 51501 2024-02-02 2024-02-02

Member

Name Role Address Appointed On
Trivium Life Services, Inc Member 4201 RIVERS EDGE PARKWAY, COUNCIL BLUFFS, IA 51501 2025-01-28

National Provider Identifier

NPI Number:
1194962829
Certification Date:
2024-12-30

Authorized Person:

Name:
MICHELLE FRANCESCA SCHALLER
Role:
SENIOR DIRECTOR OF BH & RCM
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083215069

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006265505 2025-05-27
Annual Report 0006081948 2025-01-28
Amendment to Certificate 0005976522 2024-11-18
Annual Report 0005579449 2024-02-02
Change of Registered Office/Agent/Both (by Entity) 0005551528 2024-01-02

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Date of last update: 27 Jun 2025

Sources: Idaho Secretary of State