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Watershed Wellness, LLC

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Company Details

Name: Watershed Wellness, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 17 Jan 2023 (2 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 5073392
Place of Formation: IDAHO
File Number: 858923
ZIP code: 83864
County: Bonner County
Principal Address: 417 S. LAVINA AVE SANDPOINT, ID 83864
Mailing Address: 417 S LAVINA AVE SANDPOINT, ID 83864-1144

Agent

Name Role Address
David C Barth Agent 417 S LAVINA AVE, SANDPOINT, ID 83864

Manager

Name Role Address Appointed On
David C Barth Manager 417 S. LAVINA AVE, SANDPOINT, ID 83864 2024-01-03

National Provider Identifier

NPI Number:
1487334264
Certification Date:
2023-07-18

Authorized Person:

Name:
MR. DAVID BARTH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006005898 2024-12-04
Annual Report 0005539827 2024-01-03
Initial Filing 0005073392 2023-01-17

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Date of last update: 19 Jun 2025

Sources: Idaho Secretary of State