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Metamorphosis Counseling and Health Center of Idaho, LLC

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Company Details

Name: Metamorphosis Counseling and Health Center of Idaho, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 18 Mar 2019 (6 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 3456698
Place of Formation: IDAHO
File Number: 658900
ZIP code: 83642
County: Ada County
Principal Address: CRYSTAL MILLER 954 N. GRAY CLOUD PL MERIDIAN, ID 83642
Mailing Address: CRYSTAL MILLER 722 BITTERROOT CT NAMPA, ID 83686

Agent

Name Role Address
Crystal M Miller Agent 2118 N AZURITE DR, CRYSTAL MILLER, KUNA, ID 83634

Manager

Name Role Address Appointed On Resigned On
Crystal M Miller Manager 5462 N BEAHAM AVE, MERIDIAN, ID 83646 2021-04-01 2024-03-30
Christopher J Tinsley Manager 2118 N AZURITE DR, KUNA, ID 83634 2024-03-30 2024-03-30
Crystal Michelle Miller Manager 2118 N AZURITE DR, KUNA, ID 83634 2024-03-30 No data

Managing Member

Name Role Address Appointed On
Crystal Michelle Miller Managing Member 722 BITTERROOT CT, NAMPA, ID 83686 2025-03-28

National Provider Identifier

NPI Number:
1760286330
Certification Date:
2025-04-02

Authorized Person:

Name:
MRS. CRYSTAL MICHELLE MILLER
Role:
EXECUTIVE DIRECTOR AND OWNER
Phone:

Taxonomy:

Selected Taxonomy:
175T00000X - Peer Specialist
Is Primary:
Yes

Contacts:

Fax:
2083757251

Filing

Filing Name Filing Number Filing date
Annual Report 0006176815 2025-03-28
Annual Report 0005663545 2024-03-30
Annual Report 0005169235 2023-03-28
Annual Report 0004626557 2022-03-01
Annual Report 0004224213 2021-04-01

USAspending Awards / Financial Assistance

Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
6000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-05-02
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:
8320.00
Total Face Value Of Loan:
8320.00

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$8,320
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$8,320
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$8,455.4
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $8,320

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State