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Whitewater Healthcare LLC

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Company Details

Name: Whitewater Healthcare LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 09 Jun 2020 (5 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 3904864
Place of Formation: NEVADA
File Number: 712803
ZIP code: 83616
County: Ada County
Principal Address: CORP LEGAL SUITE 150 1675 E. RIVERSIDE DRIVE EAGLE, ID 83616
Mailing Address: CORP LEGAL STE 150 1675 E RIVERSIDE DR EAGLE, ID 83616-7584

Agent

Name Role Address
UNIVERSAL REGISTERED AGENTS, INC. Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

Manager

Name Role Address Appointed On Resigned On
Brian Wayment Manager 1675 E RIVERSIDE DR, EAGLE, ID 83616-7584 2021-06-09 2024-06-26
John Gochnour Manager 1675 E. RIVERSIDE DR., BOISE, ID 83616 2024-06-26 No data

National Provider Identifier

NPI Number:
1619591161
Certification Date:
2025-06-03

Authorized Person:

Name:
AMBER L TUELLER
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
251G00000X - Community Based Hospice Care Agency
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006288149 2025-05-29
Annual Report 0006262432 2025-05-21
Annual Report 0005789539 2024-06-26
Annual Report 0005248497 2023-05-22
Registered Agent Name/Address Change (mass change) 0004903709 2022-09-12

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Date of last update: 07 Jul 2025

Sources: Idaho Secretary of State