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Play Adventures Pediatric Therapy LLC

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Company Details

Name: Play Adventures Pediatric Therapy LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 12 Aug 2022 (3 years ago)
Financial Date End: 31 Aug 2026
Entity Number: 4859223
Place of Formation: IDAHO
File Number: 835883
ZIP code: 83501
County: Nez Perce County
Principal Address: 807 PARK AVE LEWISTON, ID 83501
Mailing Address: 807 PARK AVE LEWISTON, ID 83501-4814

Agent

Name Role Address
Jenna Messick Agent 807 PARK AVE, LEWISTON, ID 83501

Manager

Name Role Address Appointed On Resigned On
Jesse Messick Manager 3232 6TH STREET, LEWISTON, ID 83501 2023-08-22 2024-08-04
Jenna Messick Manager 807 PARK AVE, LEWISTON, ID 83501 2023-08-22 No data

National Provider Identifier

NPI Number:
1568182020
Certification Date:
2022-09-02

Authorized Person:

Name:
JENNA A MESSICK
Role:
(SPEECH THERAPIST) OWNER/PARTER
Phone:

Taxonomy:

Selected Taxonomy:
235Z00000X - Speech-Language Pathologist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006402481 2025-08-14
Amendment to Certificate 0006110677 2025-02-16
Statement of Change of Business Mailing Address 0006110676 2025-02-16
Annual Report 0005839566 2024-08-04
Annual Report 0005369451 2023-08-22

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Date of last update: 20 Aug 2025

Sources: Idaho Secretary of State