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  5. Center for Lifetime Health, LLC

Center for Lifetime Health, LLC

Company Details

Name: Center for Lifetime Health, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 20 Jun 2023 (2 years ago)
Financial Date End: 30 Jun 2025
Entity Number: 5288296
Place of Formation: IDAHO
File Number: 884875
ZIP code: 83712
County: Ada County
Principal Address: 300 E. BANNOCK BOISE, ID 83712
Mailing Address: 111 W MAIN ST BOISE, ID 83702-7261

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2023 760762803 2024-08-11 CENTER FOR LIFETIME HEALTH 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 111 WEST MAIN STREET, SUITE 100, BOISE, ID, 83702

Signature of
Role Plan administrator
Date 2024-08-11
Name of individual signing COLLEEN SHACKELFORD
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2022 760762803 2023-10-11 CENTER FOR LIFETIME HEALTH 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E BANNOCK ST, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing JOHN ECK
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2021 760762803 2022-09-27 CENTER FOR LIFETIME HEALTH 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E BANNOCK ST, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2022-09-27
Name of individual signing JOHN ECK
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2020 760762803 2021-10-01 CENTER FOR LIFETIME HEALTH 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E BANNOCK ST, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2021-10-01
Name of individual signing JOHN ECK
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH, LLC 401(K) PROFIT SHARING PLAN 2019 760762803 2020-07-15 CENTER FOR LIFETIME HEALTH 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E BANNOCK ST, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing KAYLIE JOHNSON
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2018 760762803 2019-09-04 CENTER FOR LIFETIME HEALTH 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E. BANNOCK, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2019-09-04
Name of individual signing JOHN ECK, MD
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2017 760762803 2018-10-12 CENTER FOR LIFETIME HEALTH 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E. BANNOCK, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2018-10-12
Name of individual signing JOHN ECK, MD
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH 401(K) PROFIT SHARING PLAN 2016 760762803 2017-10-16 CENTER FOR LIFETIME HEALTH 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E. BANNOCK, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing JOHN ECK, MD
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH, LLC 401(K) PSP 2011 760762803 2013-08-21 CENTER FOR LIFETIME HEALTH, LLC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E. BANNOCK, BOISE, ID, 83712

Plan administrator’s name and address
Administrator’s EIN 760762803
Plan administrator’s name CENTER FOR LIFETIME HEALTH, LLC.
Plan administrator’s address 300 E. BANNOCK, BOISE, ID, 83712
Administrator’s telephone number 2083427400

Signature of
Role Plan administrator
Date 2013-08-21
Name of individual signing DAVID GEE
Valid signature Filed with authorized/valid electronic signature
CENTER FOR LIFETIME HEALTH, LLC 401(K) PSP 2010 760762803 2011-07-14 CENTER FOR LIFETIME HEALTH, LLC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2083427400
Plan sponsor’s address 300 E. BANNOCK, BOISE, ID, 83712

Plan administrator’s name and address
Administrator’s EIN 760762803
Plan administrator’s name CENTER FOR LIFETIME HEALTH, LLC.
Plan administrator’s address 300 E. BANNOCK, BOISE, ID, 83712
Administrator’s telephone number 2083427400

Signature of
Role Plan administrator
Date 2011-07-14
Name of individual signing DAVID GEE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Colleen M Shackelford Agent 5624 W HILL ROAD, BOISE, ID 83703

Manager

Name Role Address Appointed On
Colleen Marie Shackelford Manager 5624 W. HILL ROAD, BOISE, ID 83703 2024-09-15

Filing

Filing Name Filing Number Filing date
Statement of Change of Business Mailing Address 0005900843 2024-09-15
Annual Report 0005900841 2024-09-15
Amendment to Certificate 0005383073 2023-09-06
Initial Filing 0005288296 2023-06-20

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3208657102 2020-04-11 1087 PPP 300 E. BANNOCK ST, BOISE, ID, 83712-6207
Loan Status Date 2021-05-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 126870
Loan Approval Amount (current) 126900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 436276
Servicing Lender Name Idaho First Bank
Servicing Lender Address 475 E Deinhard Ln, MCCALL, ID, 83638-4800
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BOISE, ADA, ID, 83712-6207
Project Congressional District ID-02
Number of Employees 12
NAICS code 621112
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Sole Proprietorship
Originating Lender ID 436276
Originating Lender Name Idaho First Bank
Originating Lender Address MCCALL, ID
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 128231.58
Forgiveness Paid Date 2021-05-05

Related by officers

Colleen M Shackelford

NURSE PRACTITIONERS OF IDAHO, INC.

Related by address

No related companies by address

Date of last update: 26 Mar 2025

Sources: Idaho Secretary of State

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