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Life Thrive Wellness LLC

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Company Details

Name: Life Thrive Wellness LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 01 Sep 2021 (4 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 4397860
Place of Formation: IDAHO
File Number: 780101
ZIP code: 83705
County: Ada County
Principal Address: DESIREE MOORES STE B 270 S ORCHARD ST BOISE, ID 83705-1234

Agent

Name Role Address
Desiree Moores Agent 1729 E BOISE AVE, BOISE, ID 83706

Manager

Name Role Address Appointed On
Desiree Moores Manager 4948 W KOOTENAI ST, BOISE, ID 83705 2021-09-15

National Provider Identifier

NPI Number:
1184309288
Certification Date:
2023-06-16

Authorized Person:

Name:
DESIREE MOORES
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225X00000X - Occupational Therapist
Is Primary:
Yes

Contacts:

Fax:
2084737340

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0005827398 2024-07-23
Dissolution/Revocation - Administrative 0005514826 2023-12-16
Amendment to Certificate 0004993073 2022-11-14
Annual Report 0004924782 2022-09-26
Amendment to Certificate 0004420376 2021-09-15

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Date of last update: 16 Jun 2025

Sources: Idaho Secretary of State