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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 2025
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 1555 W SHORELINE DR, STE 100, BOISE, ID 83702

Manager

Name Role Address Appointed On
Brian Wayment Manager 1675 E RIVERSIDE DR, EAGLE, ID 83616-7584 2021-06-09
John Gochnour Manager 1675 E. RIVERSIDE DR., BOISE, ID 83616 2024-06-26

National Provider Identifier

NPI Number:
1619591161
Certification Date:
2021-03-16

Authorized Person:

Name:
LEE JOHNSON
Role:
TREASURER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005789539 2024-06-26
Annual Report 0005248497 2023-05-22
Registered Agent Name/Address Change (mass change) 0004903709 2022-09-12
Annual Report 0004777178 2022-06-09
Annual Report 0004311030 2021-06-09

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Date of last update: 18 May 2025

Sources: Idaho Secretary of State