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DIVINITY HEALTH CARE SERVICES, PLLC

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Company Details

Name: DIVINITY HEALTH CARE SERVICES, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 16 Aug 2013 (12 years ago)
Financial Date End: 31 Aug 2026
Entity Number: 392671
Place of Formation: IDAHO
File Number: 392671
ZIP code: 83686
County: Canyon County
Principal Address: 620 S ELDER ST NAMPA, ID 83686
Mailing Address: REGISTERED AGENT 620 S. ELDER ST. NAMPA, ID 83686-5212

Agent

Name Role Address
JEFFREY ROBERTS Agent 620 S. ELDER ST., NAMPA, ID 83686

Manager

Name Role Address Appointed On Resigned On
Divinity Healthcare Services, PLLC Manager 620 S. ELDER ST., , 2020-07-03 No data
Jeffrey D Roberts Manager 620 S. ELDER ST., NAMPA, ID 83687 2023-07-03 2024-07-03

National Provider Identifier

NPI Number:
1770995219

Authorized Person:

Name:
MR. JEFFREY DONALD ROBERTS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
305R00000X - Preferred Provider Organization
Is Primary:
No
Selected Taxonomy:
251E00000X - Home Health Agency
Is Primary:
Yes

Contacts:

Fax:
2083297001

Filing

Filing Name Filing Number Filing date
Annual Report 0006338603 2025-07-03
Annual Report 0005795764 2024-07-03
Annual Report 0005299445 2023-07-03
Annual Report 0004800912 2022-07-03
Annual Report 0004331761 2021-07-03

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Date of last update: 21 Jul 2025

Sources: Idaho Secretary of State