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Bloom Children's Developmental Services LLC

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Company Details

Name: Bloom Children's Developmental Services LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 23 Mar 2024 (a year ago)
Financial Date End: 31 Mar 2026
Entity Number: 5657520
Place of Formation: IDAHO
File Number: 928117
ZIP code: 83714
County: Ada County
Mailing Address: 10314 N BLACKTAIL AVE BOISE, ID 83714-9696

Agent

Name Role Address
Nakale Harrod Agent 10314 N BLACKTAIL AVE, BOISE, ID 83714

National Provider Identifier

NPI Number:
1073353967
Certification Date:
2024-06-29

Authorized Person:

Name:
KAYLA DAWN MAKAR
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QD1600X - Developmental Disabilities Clinic/Center
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006307108 2025-06-07
Dissolution/Revocation - Administrative 0006305982 2025-06-07
Initial Filing 0005657520 2024-03-23

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Date of last update: 21 Jun 2025

Sources: Idaho Secretary of State