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Prov16 LLC

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Company Details

Name: Prov16 LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 26 Jan 2021 (4 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 4144213
Place of Formation: IDAHO
File Number: 744286
ZIP code: 83854
County: Kootenai County
Principal Address: MIKE HOSKIN STE R 784 S CLEARWATER LOOP POST FALLS, ID 83854-9599
Mailing Address: MIKE HOSKIN STE 122 6560 W EMERALD ST BOISE, ID 83704-8736

Manager

Name Role Address Appointed On Resigned On
Mike Hoskin Manager 4441 FOX HOLLOW #1, EUGENE, OR 97405 2021-12-24 2023-01-17

Member

Name Role Address Appointed On
Mike Hoskin Member 1111 S. ORCHARD ST. STE 111, BOISE, ID 83705 2023-01-17

Agent

Name Role Address
REGISTERED AGENTS INC Agent 784 S CLEARWATER LOOP STE R, POST FALLS, ID 83854

National Provider Identifier

NPI Number:
1689330417
Certification Date:
2022-10-01

Authorized Person:

Name:
MS. RUTH HERRERA
Role:
DIRECTOR OF CONTRACT PROCUREMENT
Phone:

Taxonomy:

Selected Taxonomy:
3747P1801X - Personal Care Attendant
Is Primary:
No
Selected Taxonomy:
253Z00000X - In Home Supportive Care Agency
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006007585 2024-12-05
Statement of Change of Business Mailing Address 0005913210 2024-09-27
Application for Reinstatement 0005690647 2024-04-12
Dissolution/Revocation - Administrative 0005690272 2024-04-12
Annual Report 0005073131 2023-01-17

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Date of last update: 08 Jul 2025

Sources: Idaho Secretary of State