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Rekindled Spirit Marshall Mental Health, P.C.

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Company Details

Name: Rekindled Spirit Marshall Mental Health, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 28 Feb 2024 (a year ago)
Financial Date End: 28 Feb 2025
Date dissolved: 13 May 2025
Entity Number: 5615612
Place of Formation: IDAHO
File Number: 923770
ZIP code: 83714
County: Ada County
Mailing Address: ANNE MARSHALL, PMHNP 4614 N SAVANNAH LN BOISE, ID 83714-7405

Agent

Name Role Address
Anne Marshall Agent 4614 SAVANNAH LANE, BOISE, ID 83714-7405

National Provider Identifier

NPI Number:
1043057359
Certification Date:
2024-07-18

Authorized Person:

Name:
ETHEL ANNE MARSHALL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
2083239604

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0006252954 2025-05-13
Initial Filing 0005615612 2024-02-28

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Date of last update: 21 Jun 2025

Sources: Idaho Secretary of State