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PROVIDENCE NURSING SERVICES PLLC

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Company Details

Name: PROVIDENCE NURSING SERVICES PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 15 Sep 2010 (15 years ago)
Financial Date End: 30 Sep 2014
Date dissolved: 16 Dec 2014
Entity Number: 298881
Place of Formation: IDAHO
File Number: 0000298881
ZIP code: 83642
County: Ada County
Principal Address: 1008 W HONKER DR MERIDIAN, ID 83642

National Provider Identifier

NPI Number:
1700166014

Authorized Person:

Name:
MR. JACK GIFFORD WATKINS JR.
Role:
OWNER-MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
251E00000X - Home Health Agency
Is Primary:
Yes

Contacts:

Fax:
2088980308

Filing

Filing Name Filing Number Filing date
Annual Report 0002222401 2013-07-16
Annual Report 0002222400 2012-07-16
Change of Registered Office/Agent/Both (by Entity) 0002222399 2011-09-27
Annual Report 0002222397 2011-07-22
Statement of Change of Business Mailing Address 0002222398 2011-01-25

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State