Search icon

Nova Integrative Health, PLLC

Company claim

Is this your business?

Get access!

Company Details

Name: Nova Integrative Health, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 29 Jul 2020 (5 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 3949451
Place of Formation: IDAHO
File Number: 719475
ZIP code: 83605
County: Canyon County
Mailing Address: 229 E LOGAN ST CALDWELL, ID 83605-4835

Agent

Name Role Address
Johary ROdriguez Agent 229 EAST LOGAN STREET, CALDWELL, ID 83605

Manager

Name Role Address Appointed On
Johary Rodriguez Manager 28019 REDTOP RD., WILDER, ID 83676 2022-01-15

National Provider Identifier

NPI Number:
1912516303
Certification Date:
2020-07-30

Authorized Person:

Name:
JOHARY RODRIGUEZ
Role:
NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0850X - Adult Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0005939919 2024-10-11
Dissolution/Revocation - Administrative 0005936951 2024-10-11
Application for Reinstatement 0005439914 2023-10-13
Dissolution/Revocation - Administrative 0005427191 2023-10-04
Application for Reinstatement 0004947706 2022-10-09

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 18 May 2025

Sources: Idaho Secretary of State