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Avanzar Wellness LLC

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Company Details

Name: Avanzar Wellness LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 13 Dec 2019 (6 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 3709029
Place of Formation: IDAHO
File Number: 691057
ZIP code: 83709
County: Ada County
Principal Address: 7665 W MORNING CT BOISE, ID 83709
Mailing Address: STE 160 10096 W FAIRVIEW AVE BOISE, ID 83704-5004

Agent

Name Role Address
Jose Carbajal Agent 10096 W. FAIRVIEW AVE, STE. 160, BOISE, ID 83704

Manager

Name Role Address Appointed On Resigned On
Jose L Carbajal Manager 10096 W. FAIRVIEW AVE, BOISE, ID 83704 2020-11-05 2023-11-06
Kara M Kreizenbeck Manager 10096W FAIRVIEW AVE, BOISE, ID 83704 2023-11-06 No data

National Provider Identifier

NPI Number:
1871126797
Certification Date:
2025-06-02

Authorized Person:

Name:
JOSE CARBAJAL
Role:
DIRECTOR OF OPERATIONS
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
103T00000X - Psychologist
Is Primary:
Yes

Contacts:

Fax:
2089087883

Filing

Filing Name Filing Number Filing date
Annual Report Amendment 0006259984 2025-05-19
Annual Report 0005957374 2024-11-03
Statement of Change of Business Mailing Address 0005640560 2024-03-07
Change of Registered Office/Agent/Both (by Entity) 0005469734 2023-11-07
Annual Report 0005466038 2023-11-06

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Date of last update: 07 Jul 2025

Sources: Idaho Secretary of State