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Dybka Behavioral Health PLLC

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Company Details

Name: Dybka Behavioral Health PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 Feb 2021 (4 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 4168034
Place of Formation: IDAHO
File Number: 746522
ZIP code: 83714
County: Ada County
Principal Address: STE 379 9169 W STATE ST GARDEN CITY, ID 83714-1733
Mailing Address: 9169 W STATE ST PMB 379 GARDEN CITY, ID 83714-1733

Agent

Name Role Address
PhysicalAddress .com Agent 9169 W STATE STREET, GARDEN CITY, ID 83714

Manager

Name Role Address Appointed On
Brooke Dybka Manager 2033 MESA CANYON DRIVE, IDAHO FALLS, ID 83401 2022-01-03

National Provider Identifier

NPI Number:
1831842384
Certification Date:
2024-04-09

Authorized Person:

Name:
BROOKE DYBKA
Role:
THERAPIST / OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
2088201495

Filing

Filing Name Filing Number Filing date
Annual Report 0006044124 2025-01-03
Amendment to Certificate 0005912406 2024-09-26
Change of Registered Office/Agent/Both (by Entity) 0005912044 2024-09-25
Annual Report 0005535176 2024-01-03
Statement of Change of Business Mailing Address 0005445306 2023-10-19

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Date of last update: 15 Apr 2025

Sources: Idaho Secretary of State