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Azure Stone Mental Health & Wellness LLC

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Company Details

Name: Azure Stone Mental Health & Wellness LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 08 Jan 2024 (a year ago)
Financial Date End: 31 Jan 2026
Entity Number: 5549552
Place of Formation: WYOMING
File Number: 915108
Principal Address: SUITE R 30 N GOULD ST SHERIDAN, WY 82801
Mailing Address: STE R 30 N GOULD ST SHERIDAN, WY 82801-6317

Agent

Name Role Address
Nathan Carter Agent 2440 LEGACY DR, POCATELLO, ID 83201

Managing Member

Name Role Address Appointed On
Roland Cliff Park Managing Member 974 SOUTH 980 WEST, MAPLETON, UT 84664 2025-01-03

National Provider Identifier

NPI Number:
1922879394
Certification Date:
2025-01-28

Authorized Person:

Name:
DANIEL SPRINGER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006045471 2025-01-03
Initial Filing 0005549552 2024-01-08

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Date of last update: 22 May 2025

Sources: Idaho Secretary of State