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Shadow Pines Health & Wellness, LLC

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Company Details

Name: Shadow Pines Health & Wellness, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 28 Feb 2023 (2 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 5128063
Place of Formation: IDAHO
File Number: 866305
ZIP code: 83616
County: Ada County
Principal Address: 1786 N PRESTWICK WAY EAGLE, ID 83616
Mailing Address: JOSLYN SCIARRINO PO BOX 1515 MERIDIAN, ID 83680

Agent

Name Role Address
Joslyn H Sciarrino Agent 6916 S CADENCE AVE, MERIDIAN, ID 83642

Member

Name Role Address Appointed On Resigned On
Marc Sciarrino Member 1786 N PRESTWICK WAY, EAGLE, ID 83616 2024-02-05 2024-02-05

Manager

Name Role Address Appointed On
Joslyn Sciarrino Manager 1786 N PRESTWICK WAY, EAGLE, ID 83616-6688 2023-03-22

National Provider Identifier

NPI Number:
1851094619
Certification Date:
2023-03-22

Authorized Person:

Name:
JOSLYN SCIARRINO
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
9843550375

Filing

Filing Name Filing Number Filing date
Annual Report 0006155436 2025-03-10
Annual Report 0005586999 2024-02-05
Amendment to Certificate 0005164933 2023-03-22
Statement of Change of Business Mailing Address 0005164930 2023-03-22
Initial Filing 0005128063 2023-02-28

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Date of last update: 10 Jul 2025

Sources: Idaho Secretary of State