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Boise Behavioral Medicine PLLC

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Company Details

Name: Boise Behavioral Medicine PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Dec 2022 (3 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 5031287
Place of Formation: IDAHO
File Number: 853994
ZIP code: 83704
County: Ada County
Principal Address: BOISE BEHAVIORAL MEDICINE PLLC 7227 POTOMAC DR. BOISE, ID 83704
Mailing Address: BOISE BEHAVIORAL MEDICINE PLLC 7227 W POTOMAC DR BOISE, ID 83704-9109

Agent

Name Role Address
Vantage Group Accounting PLLC Agent 1509 S TYRELL LN, # 180, BOISE, ID 83706

Manager

Name Role Address Appointed On
Todd A Salzsieder Manager 7227 POTOMAC DR., BOISE, ID 83706 2023-11-06

National Provider Identifier

NPI Number:
1003598020
Certification Date:
2023-08-03

Authorized Person:

Name:
TODD SALZSIEDER
Role:
PA
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005970561 2024-11-07
Annual Report 0005466735 2023-11-06
Initial Filing 0005031287 2022-12-15

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Date of last update: 19 Jun 2025

Sources: Idaho Secretary of State