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Treasure Valley Psychiatry and Mental Health PLLC

Company Details

Name: Treasure Valley Psychiatry and Mental Health PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 18 Jun 2019 (6 years ago)
Financial Date End: 30 Jun 2022
Date dissolved: 15 Sep 2022
Entity Number: 3541239
Place of Formation: IDAHO
File Number: 670282
ZIP code: 83705
County: Ada County
Principal Address: STE 108 5440 W FRANKLIN RD BOISE, ID 83705
Mailing Address: 333 W CEDAR ST # 3 POCATELLO, ID 83201-5045

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 401(K) PLAN 2023 842407348 2024-01-24 TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621112
Sponsor’s telephone number 2082525621
Plan sponsor’s address 333 WEST CEDAR STREET, SUITE #3, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2024-01-24
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 401(K) PLAN 2022 842407348 2023-05-27 TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621112
Sponsor’s telephone number 2082525621
Plan sponsor’s address 333 WEST CEDAR STREET, SUITE #3, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2023-05-27
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 401(K) PLAN 2021 842407348 2022-06-01 TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621112
Sponsor’s telephone number 2082525621
Plan sponsor’s address 333 WEST CEDAR STREET, SUITE #3, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2022-06-01
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 401(K) PLAN 2020 842407348 2021-07-16 TREASURE VALLEY PSYCHIATRY AND MENTAL HEALTH 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621112
Sponsor’s telephone number 2082525621
Plan sponsor’s address 333 WEST CEDAR STREET, SUITE #3, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2021-07-15
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Adam Hunsaker Agent 333 W CEDAR ST, STE 3, POCATELLO, ID 83201

Member

Name Role Address Appointed On
Cody Haas Member 333 W FRANKLIN RD, BOISE, ID 83705 2021-08-30

Manager

Name Role Address Appointed On Resigned On
Cody Haas Manager 5440 W FRANKLIN RD, BOISE, ID 83705 2020-07-02 2021-08-30

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004914238 2022-09-15
Change of Registered Office/Agent/Both (by Entity) 0004551573 2022-01-03
Annual Report Amendment 0004443671 2021-10-11
Amendment to Certificate 0004396010 2021-08-30
Annual Report 0004304754 2021-06-03
Annual Report 0003925053 2020-07-02
Initial Filing 0003541239 2019-06-18

Date of last update: 31 Dec 2024

Sources: Idaho Secretary of State