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SULLIVAN MENTAL HEALTH SERVICES, LLC

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Company Details

Name: SULLIVAN MENTAL HEALTH SERVICES, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 21 Jul 2010 (15 years ago)
Financial Date End: 31 Jul 2022
Date dissolved: 05 Oct 2022
Entity Number: 294503
Place of Formation: IDAHO
File Number: 294503
ZIP code: 83404
County: Bonneville County
Principal Address: 1904 JENNIE LEE DRIVE IDAHO FALLS, ID 83404
Mailing Address: 1904 JENNIE LEE DR IDAHO FALLS, ID 83404-6159

Agent

Name Role Address
ELAINE SULLIVAN Agent 3785 COLTS GLEN LANE, IDAHO FALLS, ID 83404

Manager

Name Role Address Appointed On
Elaine Sullivan Manager 1904 JENNIE LEE DR, IDAHO FALLS, ID 83404 2020-10-29

National Provider Identifier

NPI Number:
1003101577

Authorized Person:

Name:
MRS. JESSIE ELAINE SULLIVAN
Role:
OWNER/THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0850X - Adult Mental Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2085294788

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004936529 2022-10-05
Annual Report 0004308676 2021-06-07
Application for Reinstatement 0004044685 2020-10-29
Dissolution/Revocation - Administrative 0004031904 2020-10-14
Annual Report 0003602046 2019-08-21

USAspending Awards / Financial Assistance

Date:
2020-04-16
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:
-100.00
Total Face Value Of Loan:
63800.00

Paycheck Protection Program

Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
63900
Current Approval Amount:
63800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
64250.97

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Date of last update: 27 Jun 2025

Sources: Idaho Secretary of State