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ESPERANZA MENTAL HEALTH PLLC

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Company Details

Name: ESPERANZA MENTAL HEALTH PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 07 Nov 2012 (13 years ago)
Financial Date End: 30 Nov 2013
Date dissolved: 14 Feb 2014
Entity Number: 364977
Place of Formation: IDAHO
File Number: 0000364977
ZIP code: 83401
County: Bonneville County
Principal Address: 1680 WOODRUFF PARK IDAHO FALLS, ID 83401

National Provider Identifier

NPI Number:
1063760452

Authorized Person:

Name:
MS. MARIE LYNN ALLEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0000364977 2012-11-07

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Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State