Search icon

BOISE KETAMINE CLINIC PLLC

Company claim

Is this your business?

Get access!

Company Details

Name: BOISE KETAMINE CLINIC PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 20 May 2016 (9 years ago)
Financial Date End: 31 May 2026
Entity Number: 506096
Place of Formation: IDAHO
File Number: 506096
ZIP code: 83705
County: Ada County
Principal Address: 2800 W OVERLAND RD BOISE, ID 83705
Mailing Address: 2800 W OVERLAND RD BOISE, ID 83705-3038

Agent

Name Role Address
NYKOL RICE Agent 13691 W ANNABROOK DR, BOISE, ID 83713

Member

Name Role Address Appointed On
Nykol B Rice Member 13691 W ANNABROOK DR, BOISE, ID 83713 2022-06-03

Manager

Name Role Address Appointed On Resigned On
Nykol B Rice Manager 13691 W ANNABROOK DR, BOISE, ID 83713 2021-04-26 2022-06-03
Jeremy R Rice Manager 13691 W ANNABROOK DR, BOISE, ID 83713 2024-04-10 2024-04-10

National Provider Identifier

NPI Number:
1518547140
Certification Date:
2021-03-25

Authorized Person:

Name:
NYKOL BAILEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QI0500X - Infusion Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2082072866

Filing

Filing Name Filing Number Filing date
Annual Report 0006249803 2025-05-12
Annual Report 0005686851 2024-04-10
Annual Report 0005176571 2023-04-03
Amendment to Certificate 0004767396 2022-06-03
Annual Report 0004715447 2022-04-25

USAspending Awards / Financial Assistance

Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
1000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 02 Jul 2025

Sources: Idaho Secretary of State