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TOTAL LIFE CLINIC, PLLC

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Company Details

Name: TOTAL LIFE CLINIC, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 Apr 2016 (9 years ago)
Financial Date End: 30 Apr 2025
Entity Number: 500240
Place of Formation: IDAHO
File Number: 500240
ZIP code: 83318
County: Cassia County
Principal Address: STE 6 2311 PARK AVE BURLEY, ID 83318-2104
Mailing Address: LACIE ASHER STE 6 2311 PARK AVE BURLEY, ID 83318-2104

Agent

Name Role Address
LACIE ASHER FNP C Agent 2311 PARK AVE, STE 6, BURLEY, ID 83318

Manager

Name Role Address Appointed On
CLAUDIA MILLER Manager 2313 PARKE AVE. STE 1, BURLEY, ID 83318 2021-03-09
Shelbyann B Aldridge Manager 2313 PARKE AVE, BURLEY, ID 83318 2022-04-05

National Provider Identifier

NPI Number:
1467816199
Certification Date:
2023-03-16

Authorized Person:

Name:
SHELBYANN BERNICE ALDRIDGE
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2088786417

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0005832054 2024-07-30
Dissolution/Revocation - Administrative 0005318883 2023-07-13
Annual Report 0004689176 2022-04-05
Annual Report 0004202979 2021-03-09
Annual Report 0003840067 2020-04-08

USAspending Awards / Financial Assistance

Date:
2021-02-06
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
34070.00
Total Face Value Of Loan:
34070.00
Date:
2020-07-31
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
99500.00
Total Face Value Of Loan:
473700.00
Date:
2020-04-28
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
34000.00
Total Face Value Of Loan:
34000.00

Paycheck Protection Program

Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
34000
Current Approval Amount:
34000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
34210.52
Date Approved:
2021-02-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
34070
Current Approval Amount:
34070
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
34189.48

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Date of last update: 06 Jun 2025

Sources: Idaho Secretary of State