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MENTAL WELLNESS CLINIC OF COEUR D'ALENE, INC.

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Company Details

Name: MENTAL WELLNESS CLINIC OF COEUR D'ALENE, INC.
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Active-Good Standing
Date of registration: 04 Dec 2006 (19 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 515765
Place of Formation: IDAHO
File Number: 515765
ZIP code: 83814
County: Kootenai County
Mailing Address: KELLY LAGROU 1105 W IRONWOOD DR COEUR D ALENE, ID 83814-2613

President

Name Role Address Appointed On
Kelly P Lagrou President 5760 N HARCOURT DRIVE, COEUR D'ALENE, ID 83815 2020-11-30

Agent

Name Role Address
Kelly Lagrou Agent 1105 W IRONWOOD DR, COEUR D ALENE, ID 83814-2613

National Provider Identifier

NPI Number:
1629429782

Authorized Person:

Name:
KELLY LAGROU
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Fax:
2086761009

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0006171785 2025-03-25
Application for Reinstatement 0006172783 2025-03-25
Annual Report 0005509141 2023-12-12
Annual Report 0005009698 2022-12-04
Annual Report 0004491477 2021-11-08

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Date of last update: 03 Jul 2025

Sources: Idaho Secretary of State