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Mobile Rehab Group LLC

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Company Details

Name: Mobile Rehab Group LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 27 Aug 2020 (5 years ago)
Financial Date End: 31 Aug 2021
Date dissolved: 09 Sep 2021
Entity Number: 3980860
Place of Formation: IDAHO
File Number: 723451
ZIP code: 83616
County: Ada County
Principal Address: JIM JOHNSON 516 S WOODDALE PL EAGLE, ID 83616
Mailing Address: JIM JOHNSON 516 S WOODDALE PL EAGLE, ID 83616-7713

Agent

Name Role Address
TOM CZARNIECKI Agent 10532 W BUSINESS PARK LN, BOISE, ID 83709

National Provider Identifier

NPI Number:
1629685029
Certification Date:
2020-09-29

Authorized Person:

Name:
JAMES PHILLIP JOHNSON
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
2085042821

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0004412668 2021-09-09
Initial Filing 0003980860 2020-08-27

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Date of last update: 07 Jul 2025

Sources: Idaho Secretary of State