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RESILIENCE PSYCHIATRIC MEDICINE PLLC

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Company Details

Name: RESILIENCE PSYCHIATRIC MEDICINE PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 02 Jul 2014 (11 years ago)
Financial Date End: 31 Jul 2020
Date dissolved: 15 Oct 2020
Entity Number: 425766
Place of Formation: IDAHO
File Number: 425766
ZIP code: 83814
County: Kootenai County
Principal Address: 1110 W PARK PL 310 COEUR D ALENE, ID 83814
Mailing Address: Nicole Carlberg STE A 2426 N MERRITT CREEK LOOP COEUR D ALENE, ID 83814-4961

Agent

Name Role Address
NICOLE CARLBERG DO Agent 1110 W PARK PL, STE 310, COEUR D ALENE, ID 83814

National Provider Identifier

NPI Number:
1760893945
Certification Date:
2019-12-23

Authorized Person:

Name:
NICOLE CARLBERG
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
2082922189
Fax:
2086659879

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004033019 2020-10-15
Annual Report 0003608632 2019-08-28
Statement of Change of Business Mailing Address 0003607769 2019-08-27
Annual Report 0002814588 2018-08-14
Annual Report 0002814587 2017-08-30

USAspending Awards / Financial Assistance

Date:
2020-05-13
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
43521.15
Total Face Value Of Loan:
0.00

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Date of last update: 01 Jul 2025

Sources: Idaho Secretary of State