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Bloom Idaho, LLC

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Company Details

Name: Bloom Idaho, LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 08 May 2020 (5 years ago)
Financial Date End: 31 May 2025
Entity Number: 3872786
Place of Formation: UTAH
File Number: 708923
ZIP code: 83714
County: Ada County
Principal Address: 6965 N GLENWOOD ST GARDEN CITY, ID 83714
Mailing Address: PATTY CLEAVELAND 50 HENRY ST CORTEZ, CO 81321-3012

Member

Name Role Address Appointed On
Bloom Care LLC Member 50 HENRY ST, CORTEZ, CO 81321 2021-04-20

Manager

Name Role Address Appointed On
Spencer Smith Manager 50 HENRY ST, CORTEZ, CO 81321 2024-04-03

Agent

Name Role Address
Cole Weir Agent 1644 ANGELA ST, CHUBBUCK, ID 83202

National Provider Identifier

NPI Number:
1841934866
Certification Date:
2023-01-04

Authorized Person:

Name:
SPENCER SMITH
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QU0200X - Urgent Care Clinic/Center
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005667083 2024-04-03
Annual Report 0005267248 2023-06-05
Annual Report 0004717742 2022-04-27
Annual Report 0004252244 2021-04-20
Initial Filing 0003872786 2020-05-08

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Date of last update: 07 Jul 2025

Sources: Idaho Secretary of State