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Revive Mental Wellness LLC

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Company Details

Name: Revive Mental Wellness LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 08 Nov 2022 (3 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 4985392
Place of Formation: WYOMING
File Number: 848890
Principal Address: STE 1200 1309 COFFEEN AVE SHERIDAN, WY 82801
Mailing Address: REVIVE MENTAL WELLNESS 1200 N MAIN ST # 1623 MERIDIAN, ID 83680-5065

Member

Name Role Address Appointed On
Jynnah Snow Member 1200 N MAIN ST # 1623, MERIDIAN, ID 83646 2023-10-16

Agent

Name Role Address
ALL DAY $49 IDAHO REGISTERED AGENT LLC Agent 784 S CLEARWATER LOOP STE F, POST FALLS, ID 83854

National Provider Identifier

NPI Number:
1326756347
Certification Date:
2023-01-01

Authorized Person:

Name:
JYNNAH L SNOW
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005934518 2024-10-09
Annual Report 0005442034 2023-10-16
Initial Filing 0004985392 2022-11-08

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Date of last update: 26 Mar 2025

Sources: Idaho Secretary of State