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Prosper Health LLC

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Company Details

Name: Prosper Health LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 Mar 2023 (2 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 5156049
Place of Formation: IDAHO
File Number: 868809
ZIP code: 83202
County: Bannock County
Principal Address: 440 CALLAWAY DR POCATELLO, ID 83202
Mailing Address: 440 CALLAWAY DR POCATELLO, ID 83202-5079

Agent

Name Role Address
Tayte Lackey Agent 440 CALLAWAY DR, POCATELLO, ID 83202

Manager

Name Role Address Appointed On Resigned On
Tayte Lackey Manager 440 CALLAWAY DR, POCATELLO, ID 83202 2024-04-12 2024-04-12

Member

Name Role Address Appointed On
Chester Lackey Member 440 CALLAWAY DR, POCATELLO, ID 83202-5079 2023-03-29

National Provider Identifier

NPI Number:
1407695224
Certification Date:
2024-05-21

Authorized Person:

Name:
CHESTER LACKEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
276400000X - Substance Use Disorder Rehabilitation Hospital Unit
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006196658 2025-04-06
Annual Report 0005691480 2024-04-12
Amendment to Certificate 0005170713 2023-03-29
Initial Filing 0005156049 2023-03-14

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Date of last update: 25 Jul 2025

Sources: Idaho Secretary of State