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North Idaho Mobile OT PLLC

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Company Details

Name: North Idaho Mobile OT PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 13 Dec 2022 (2 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 5029346
Place of Formation: IDAHO
File Number: 853713
ZIP code: 83814
County: Kootenai County
Principal Address: 5925 W RIVERVIEW DR COEUR D ALENE, ID 83814
Mailing Address: 5925 W RIVERVIEW DR COEUR D ALENE, ID 83814-7705

Agent

Name Role Address
Christopher Taylor Agent 5925 W RIVERVIEW DR, COEUR D ALENE, ID 83814

Manager

Name Role Address Appointed On Resigned On
Christopher D Taylor Manager 5925 W RIVERVIEW DR, COEUR D ALENE, ID 83814 2023-11-03 2023-11-03

Member

Name Role Address Appointed On
Christopher Stoddard Member 31200 N FIR RD, ATHOL, ID 83801 2023-02-16

National Provider Identifier

NPI Number:
1609581677
Certification Date:
2023-01-13

Authorized Person:

Name:
KIP TAYLOR
Role:
FOUNDER
Phone:

Taxonomy:

Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006029365 2024-12-17
Annual Report 0005456919 2023-11-03
Amendment to Certificate 0005110894 2023-02-16
Change of Registered Office/Agent/Both (by Entity) 0005088557 2023-02-01
Initial Filing 0005029346 2022-12-13

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Date of last update: 26 Mar 2025

Sources: Idaho Secretary of State