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Boise Outdoor OT, LLC
Company Details
| Name: |
Boise Outdoor OT, LLC |
| Jurisdiction: |
Idaho |
| Legal type: |
Limited Liability Company (D) |
| Status: |
Active-Existing
|
| Date of registration: |
29 Apr 2021 (4 years ago)
|
| Financial Date End: |
30 Apr 2026 |
| Entity Number: |
4259304 |
| Place of Formation: |
IDAHO |
| File Number: |
761049 |
| ZIP code: |
83714
|
| County: |
Ada County |
| Principal Address: |
522 EAST 40TH STREET BOISE, ID 83714 |
| Mailing Address: |
BOISE OUTDOOR OT 522 E 40TH ST GARDEN CITY, ID 83714-6358 |
Agent
| Name |
Role |
Address |
|
Daniele Fallon
|
Agent
|
522 E 40TH STREET, GARDEN CITY, ID 83714
|
Manager
| Name |
Role |
Address |
Appointed On |
Resigned On |
|
Daniele Fallon
|
Manager
|
522 E. 40TH STREET, GARDEN CITY, ID 83714
|
2021-07-06
|
2022-07-21
|
Member
| Name |
Role |
Address |
Appointed On |
|
Daniele Fallon
|
Member
|
522 E 40TH ST, GARDEN CITY, ID 83714-6358
|
2022-07-21
|
National Provider Identifier
Certification Date:
2021-11-15
Authorized Person:
Name:
MRS. DANIELE FALLON
Role:
OCCUPATIONAL THERAPIST
Taxonomy:
Selected Taxonomy:
225XP0200X - Pediatric Occupational Therapist
Contacts:
This company hasn't received any reviews.
Date of last update: 19 May 2025
Sources:
Idaho Secretary of State
