Search icon

AUTUMN LEAVES PSYCHIATRY, PLLC

Company claim

Is this your business?

Get access!

Company Details

Name: AUTUMN LEAVES PSYCHIATRY, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 12 Mar 2021 (5 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 4206201
Place of Formation: IDAHO
File Number: 752445
ZIP code: 83404
County: Bonneville County
Principal Address: STE 4 3670 S 25TH E IDAHO FALLS, ID 83404
Mailing Address: STE 4 3670 S 25TH E IDAHO FALLS, ID 83404-4956

Agent

Name Role Address
MERJURIE FAIR RICKLEFS Agent 244 CALISTOGA DRIVE, IDAHO FALLS, ID 83404

Manager

Name Role Address Appointed On
MERJURIE FAIR RICKLEFS Manager PO BOX 3470, IDAHO FALLS, ID 83403-3470 2021-08-04

Member

Name Role Address Appointed On Resigned On
BRYCE D RICKLEFS Member 3670 S 25TH E, IDAHO FALLS, ID 83404 2024-02-05 2024-02-05

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Fax Number:
986-497-0071
Contact Person:
BRYCE RICKLEFS
Ownership and Self-Certifications:
Asian Pacific American, Other Minority Owned, Self-Certified Small Disadvantaged Business, Service-Disabled Veteran, Veteran, Women-Owned Small Business, Woman Owned
User ID:
P3245078

Unique Entity ID

Unique Entity ID:
NSRZFFLEJ6U3
CAGE Code:
9U3P8
UEI Expiration Date:
2025-03-22

Business Information

Activation Date:
2024-03-26
Initial Registration Date:
2024-02-21

Commercial and government entity program

CAGE number:
9U3P8
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-03-22
CAGE Expiration:
2029-03-26
SAM Expiration:
2025-03-22

Contact Information

POC:
BRYCE RICKLEFS
Corporate URL:
https://www.autumnleavespsychiatry.com/

National Provider Identifier

NPI Number:
1396326096
Certification Date:
2021-05-06

Authorized Person:

Name:
MERJURIE F RICKLEFS
Role:
PSYCHIATRIC NURSE PRACTITIONER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006089412 2025-02-03
Annual Report 0005585767 2024-02-05
Annual Report 0005093296 2023-02-03
Annual Report 0004595749 2022-02-04
Amendment to Certificate 0004369920 2021-08-04

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 12 Sep 2025

Sources: Idaho Secretary of State