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Sloan Psychiatric Care, PLLC

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Company Details

Name: Sloan Psychiatric Care, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Jul 2023 (2 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 5323630
Place of Formation: IDAHO
File Number: 888728
ZIP code: 83617
County: Gem County
Principal Address: KATHLEEN MACK 1006 VANDERDASSON RD EMMETT, ID 83617
Mailing Address: KATHLEEN MACK 1006 VANDERDASSON RD EMMETT, ID 83617-8880

Agent

Name Role Address
Kathleen Ann Mack Agent 1006 VANDERDASSON RD, EMMETT, ID 83617

Manager

Name Role Address Appointed On
Kathleen Ann Mack Manager 1006 VANDERDASSON RD, EMMETT, ID 83617 2024-07-03

National Provider Identifier

NPI Number:
1992581235
Certification Date:
2023-10-13

Authorized Person:

Name:
KATHLEEN ANN MACK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
2089446067

Filing

Filing Name Filing Number Filing date
Annual Report 0005798060 2024-07-03
Initial Filing 0005323630 2023-07-15

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Date of last update: 27 Mar 2025

Sources: Idaho Secretary of State