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Magic Valley ABA Therapy LLC

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Company Details

Name: Magic Valley ABA Therapy LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Feb 2024 (a year ago)
Financial Date End: 28 Feb 2026
Entity Number: 5612565
Place of Formation: IDAHO
File Number: 923214
ZIP code: 83332
County: Twin Falls County
Principal Address: 161 W ORCHARD ST HAGERMAN, ID 83332
Mailing Address: 161 W ORCHARD ST HAGERMAN, ID 83332-5064

Agent

Name Role Address
Christa Alexandra Lewis Agent 161 ORCHARD ST WEST, HAGERMAN, ID 83332

Manager

Name Role Address Appointed On
Christa Alexandra Lewis Manager 161 W ORCHARD ST, HAGERMAN, ID, ID 83332 2025-01-03

National Provider Identifier

NPI Number:
1851157762
Certification Date:
2024-02-27

Authorized Person:

Name:
CHRISTA A LEWIS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
106S00000X - Behavior Technician
Is Primary:
No
Selected Taxonomy:
261QD1600X - Developmental Disabilities Clinic/Center
Is Primary:
No
Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006044135 2025-01-03
Change of Registered Office/Agent/Both (by Entity) 0005747921 2024-06-03
Initial Filing 0005612565 2024-02-25

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Date of last update: 22 May 2025

Sources: Idaho Secretary of State