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Allegiant Idaho LLC

Allegiant Idaho LLC

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Company Details

Name:	Allegiant Idaho LLC
Jurisdiction:	Idaho
Legal type:	Limited Liability Company (D)
Status:	Active-Existing
Date of registration:	20 Oct 2023 (2 years ago)
Financial Date End:	31 Oct 2025
Entity Number:	5445948
Place of Formation:	IDAHO
File Number:	903931
ZIP code:	83686
County:	Canyon County
Principal Address:	114 119 S VALLEY DR NAMPA, ID 83686
Mailing Address:	119 S VALLEY DR # 114 NAMPA, ID 83686-2974

Agent

Name	Role	Address
Lane C Gould	Agent	119 S VALLEY DRIVE, STE A # 114, NAMPA, ID 83686

Member

Name	Role	Address	Appointed On
Jennifer L. Gould	Member	119 S VALLEY DR # 114, NAMPA, ID 83686-2974	2024-09-04

National Provider Identifier

NPI Number:

1821864125

Certification Date:

2025-04-08

Link:

View on NPI website

Authorized Person:

Name:

MRS. TRACY BERRY

Role:

EXECUTIVE DIRECTOR

Phone:

2084660987

Taxonomy:

Selected Taxonomy:

251J00000X - Nursing Care Agency

Is Primary:

Yes

Contacts:

Phone:

+1 208-466-0987

Fax:

2084660985

Filing

Filing Name	Filing Number	Filing date
Annual Report	0005881426	2024-09-04
Initial Filing	0005445948	2023-10-20

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Date of last update: 21 May 2025

Sources: Idaho Secretary of State