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Clear Source Therapy and Clinical Resource Center LLC

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Company Details

Name: Clear Source Therapy and Clinical Resource Center LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 10 May 2022 (3 years ago)
Financial Date End: 31 May 2026
Entity Number: 4741137
Place of Formation: IDAHO
File Number: 821670
ZIP code: 83301
County: Twin Falls County
Principal Address: 392 FALLS AVE TWIN FALLS, ID 83301-3373

Agent

Name Role Address
Ezekiel Kelsey Agent 392 FALLS AVENUE, TWIN FALLS, ID 83301

Manager

Name Role Address Appointed On
Ezekiel Kelsey Manager 3231 SPRING CREEK DRIVE, TWIN FALLS, ID 83301 2025-05-14

National Provider Identifier

NPI Number:
1205571668
Certification Date:
2023-03-15

Authorized Person:

Name:
EZEKIEL KELSEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225X00000X - Occupational Therapist
Is Primary:
No
Selected Taxonomy:
235Z00000X - Speech-Language Pathologist
Is Primary:
Yes

Contacts:

Fax:
2084502408

Filing

Filing Name Filing Number Filing date
Annual Report 0006255038 2025-05-14
Application for Reinstatement 0005903445 2024-09-18
Dissolution/Revocation - Administrative 0005857534 2024-08-13
Application for Reinstatement 0005439010 2023-10-12
Dissolution/Revocation - Administrative 0005350280 2023-08-04

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Date of last update: 24 Jul 2025

Sources: Idaho Secretary of State