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VITAM PLLC

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Company Details

Name: VITAM PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 20 Feb 2013 (12 years ago)
Financial Date End: 28 Feb 2025
Date dissolved: 12 Feb 2025
Entity Number: 375070
Place of Formation: IDAHO
File Number: 375070
ZIP code: 83703
County: Ada County
Principal Address: KATHLEEN BERG STE 102 STE 102 3858 N GARDEN CENTER WAY BOISE, ID 83703-5031
Mailing Address: DR. KATHLEEN BERG, VITAM PHYSICAL THERAPY STE 102 3858 N GARDEN CENTER WAY BOISE, ID 83703-5031

Agent

Name Role Address
KATHLEEN BERG Agent 3858 N GARDEN CENTER WAY #102, SUITE102, BOISE, ID 83703

National Provider Identifier

NPI Number:
1619316460

Authorized Person:

Name:
KATHY MARIE BERG
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2251X0800X - Orthopedic Physical Therapist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0006104485 2025-02-10
Application for Reinstatement 0005932275 2024-10-07
Dissolution/Revocation - Administrative 0004271863 2021-05-05
Annual Report 0003815750 2020-03-18
Annual Report 0003441466 2019-03-05

Paycheck Protection Program

Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
3100
Current Approval Amount:
3100
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
3132.87
Date Approved:
2021-03-26
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
3100
Current Approval Amount:
3100
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
3125.9

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Date of last update: 29 Jun 2025

Sources: Idaho Secretary of State