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LIGHTHOUSE HOSPICE LLC

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Company Details

Name: LIGHTHOUSE HOSPICE LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 Nov 2016 (9 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 528622
Place of Formation: IDAHO
File Number: 528622
ZIP code: 83642
County: Ada County
Principal Address: 151 W GALVANI DRIVE SUITE 100 MERIDIAN, ID 83642
Mailing Address: JAMIE WILSON STE 110 1079 S ANCONA AVE EAGLE, ID 83616-5539

Agent

Name Role Address
JACK TRENT Agent 6213 CLOVERDALE RD STE 130, BOISE, ID 83713

Member

Name Role Address Appointed On Resigned On
SHHC LLC Member 7931 HWY 44, STAR, ID 83669 2023-10-03 2023-10-03
GMHC LLC Member 2667 E GALA CT, MERIDIAN, ID 83642 2023-10-03 2023-10-03
WADA LLC Member 2443 E 1ST STREET, FRUITLAND, ID 83619 2020-11-19 No data

National Provider Identifier

NPI Number:
1477096220
Certification Date:
2024-05-09

Authorized Person:

Name:
KELLIE ANNE STANGER
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
251G00000X - Community Based Hospice Care Agency
Is Primary:
Yes

Contacts:

Fax:
2088844048

Filing

Filing Name Filing Number Filing date
Statement of Change of Business Mailing Address 0006137891 2025-03-03
Annual Report 0005996621 2024-11-30
Annual Report 0005420134 2023-10-03
Annual Report 0005001604 2022-11-28
Annual Report 0004515909 2021-12-03

USAspending Awards / Financial Assistance

Date:
2020-04-28
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
218000.00
Total Face Value Of Loan:
218000.00

Paycheck Protection Program

Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
218000
Current Approval Amount:
218000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
219720.11

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Date of last update: 13 May 2025

Sources: Idaho Secretary of State