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Riverside Wellness LLC

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Company Details

Name: Riverside Wellness LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Jul 2023 (2 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 5331356
Place of Formation: IDAHO
File Number: 890259
ZIP code: 83221
County: Bingham County
Principal Address: 167 N 710 W BLACKFOOT, ID 83221
Mailing Address: 31 W BRIDGE ST BLACKFOOT, ID 83221

Manager

Name Role Address Appointed On
Ashton Wayne Holbrook Manager 167 N 710 W, BLACKFOOT, ID 83221 2024-06-18

Agent

Name Role Address
Ashton Wayne Holbrook Agent 167 N 710 W, BLACKFOOT, ID 83221

National Provider Identifier

NPI Number:
1750161980
Certification Date:
2023-10-04

Authorized Person:

Name:
ASHTON W HOLBROOK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005783238 2024-06-18
Initial Filing 0005331356 2023-07-25

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Date of last update: 27 Mar 2025

Sources: Idaho Secretary of State