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Counseling and Treatment Center of Idaho, LLC

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Company Details

Name: Counseling and Treatment Center of Idaho, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 11 Sep 2023 (2 years ago)
Financial Date End: 30 Sep 2024
Date dissolved: 13 Dec 2024
Entity Number: 5398435
Place of Formation: IDAHO
File Number: 897745
ZIP code: 83440
County: Madison County
Principal Address: 339 EAST 7TH NORTH REXBURG, ID 83440
Mailing Address: ERIC FERNELIUS 339 EAST 7TH NORTH REXBURG, ID 83440

Agent

Name Role Address
Eric Fernelius Agent 339 EAST 7TH NORTH, REXBURG, ID 83440

National Provider Identifier

NPI Number:
1336885136
Certification Date:
2022-05-05

Authorized Person:

Name:
ERIC FERNELIUS
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0006023874 2024-12-13
Initial Filing 0005398435 2023-09-11

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Date of last update: 22 Aug 2025

Sources: Idaho Secretary of State