Search icon

FAMILY AND FUNCTIONAL MEDICINE OF IDAHO PLLC

Company claim

Is this your business?

Get access!

Company Details

Name: FAMILY AND FUNCTIONAL MEDICINE OF IDAHO PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 08 Jun 2011 (14 years ago)
Financial Date End: 30 Jun 2019
Date dissolved: 03 Oct 2019
Entity Number: 321025
Place of Formation: IDAHO
File Number: 321025
ZIP code: 83714
County: Ada County
Principal Address: 12354 N HUMPHREYS WAY BOISE, ID 83714

Agent

Name Role Address
ANGELA L HOUSE DO Agent 12354 N HUMPHREYS WAY, BOISE, ID 83714

National Provider Identifier

NPI Number:
1114352242

Authorized Person:

Name:
ANGELA L HOUSE
Role:
PHYSICIAN / OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2089470926

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0003639120 2019-10-03
Annual Report 0002344143 2018-05-06
Annual Report 0002344141 2017-06-25
Annual Report 0002344139 2016-06-05
Annual Report 0002344137 2015-07-13

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 28 Jun 2025

Sources: Idaho Secretary of State