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IDAHO PSYCHIATRIC INSTITUTE

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Company Details

Name: IDAHO PSYCHIATRIC INSTITUTE
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Inactive-Cancelled
Date of registration: 10 Oct 2006 (19 years ago)
Entity Number: 322610
Place of Formation: IDAHO
File Number: 0000322610
ZIP code: 83406
County: Bonneville County
Mailing Address: 1675 CURLEW IDAHO FALLS, ID 83406

National Provider Identifier

NPI Number:
1285959908

Authorized Person:

Name:
SHAWN THURBER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
225X00000X - Occupational Therapist
Is Primary:
Yes

Contacts:

Fax:
2085291627

Filing

Filing Name Filing Number Filing date
Cancellation of Certificate of Assumed Business Name 0000855041 2008-07-28
Initial Filing 0000322610 2006-10-10

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State