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Evergreen Integrative Mental Health Care LLC

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Company Details

Name: Evergreen Integrative Mental Health Care LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 06 Nov 2023 (2 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 5467545
Place of Formation: IDAHO
File Number: 906313
ZIP code: 83301
County: Twin Falls County
Principal Address: SHEILA GREEN 595 MOUNTAIN VIEW DR. TWIN FALLS, ID 83301
Mailing Address: SHEILA GREEN 595 MOUNTAIN VIEW DR TWIN FALLS, ID 83301-4319

Agent

Name Role Address
Sheila M Green Agent 595 MOUNTAIN VIEW DRIVE, TWIN FALLS, ID 83301

Manager

Name Role Address Appointed On
Sheila M. Green Manager 595 MT. VIEW DR., TWIN FALLS, ID 83301 2024-10-04

National Provider Identifier

NPI Number:
1760247639
Certification Date:
2024-02-19

Authorized Person:

Name:
MS. SHEILA MARIE GREEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Fax:
2087181106

Filing

Filing Name Filing Number Filing date
Annual Report 0005929860 2024-10-04
Initial Filing 0005467545 2023-11-06

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Date of last update: 17 Apr 2025

Sources: Idaho Secretary of State