SELECT MEDICAL NETWORK OF IDAHO, INC.
| Name: | SELECT MEDICAL NETWORK OF IDAHO, INC. |
| Jurisdiction: | Idaho |
| Legal type: | Non-Profit Corporation (D) |
| Status: | Active-Good Standing |
| Date of registration: | 12 Dec 2002 (22 years ago) |
| Financial Date End: | 31 Dec 2025 |
| Entity Number: | 446343 |
| Place of Formation: | IDAHO |
| File Number: | 446343 |
| ZIP code: | 83712 |
| County: | Ada County |
| Mailing Address: | 190 E BANNOCK ST BOISE, ID 83712-6241 |
| Name | Role | Address |
|---|---|---|
| CHRISTINE S NEUHOFF, ESQ | Agent | 190 E BANNOCK ST, BOISE, ID 83712 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| Amy Gonzalez | President | 190 E. BANNOCK, BOISE, ID 83712 | 2023-02-08 | No data |
| Chris Roth | President | 190 E. BANNOCK, BOISE, ID 83712 | 2020-12-23 | 2021-12-06 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| Chris Roth | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2021-12-06 | 2023-02-08 |
| Robert Cavagnol MD | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Dick Armstrong | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Randell Page DO | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Jim Giuffre | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Brian Fortuin MD | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Casi Wyatt DO | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| April Dillion DO | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Ernest Blackwelder | Director | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Dee Jay Mailer | Director | 190 E. BANNOCK ST., BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| Ben Keith | Secretary | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| Shelby Hendrickson | Treasurer | 190 E. BANNOCK, BOISE, ID 83712 | 2024-01-02 | 2024-01-02 |
A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.
Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a
government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity
doing business with the federal government must register for a UEI.
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Annual Report | 0006031492 | 2024-12-19 |
| Annual Report | 0005533263 | 2024-01-02 |
| Change of Registered Office/Agent/Both (by Entity) | 0005442869 | 2023-10-24 |
| Annual Report | 0005102827 | 2023-02-08 |
| Annual Report | 0004519151 | 2021-12-06 |
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Date of last update: 11 May 2025
Sources: Idaho Secretary of State