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MINI-CASSIA CARE CENTER, LLC

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Company Details

Name: MINI-CASSIA CARE CENTER, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 09 Aug 2010 (15 years ago)
Financial Date End: 31 Aug 2011
Date dissolved: 03 Nov 2011
Entity Number: 295536
Place of Formation: IDAHO
File Number: 0000295536
ZIP code: 83201
County: Bannock County
Principal Address: 275 SOUTH 5TH AVE LOWER LEVEL POCATELLO, ID 83201

National Provider Identifier

NPI Number:
1770890022

Authorized Person:

Name:
MR. JAMES B EVERTON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
2082334750
Fax:
2086783727

Filing

Filing Name Filing Number Filing date
Initial Filing 0000295536 2010-08-09

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State