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AUTUMN WIND COMMUNITY HEALTHCARE, LLC

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Company Details

Name: AUTUMN WIND COMMUNITY HEALTHCARE, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 09 May 2024 (a year ago)
Financial Date End: 31 May 2026
Entity Number: 5733441
Place of Formation: IDAHO
File Number: 936266
Principal Address: 262 N UNIVERSITY AVE FARMINGTON, UT 84025
Mailing Address: 262 N UNIVERSITY AVE FARMINGTON, UT 84025-2975

Member

Name Role Address Appointed On
PROVIDENCE GROUP NH, LLC Member 262 N UNIVERSITY AVE, FARMINGTON, UT 84025 2025-05-06

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

National Provider Identifier

NPI Number:
1407696008
Certification Date:
2024-05-30

Authorized Person:

Name:
JOHN MITCHELL
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
311500000X - Alzheimer Center (Dementia Center)
Is Primary:
No
Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report Amendment 0006242052 2025-05-06
Statement of Change of Business Mailing Address 0006242024 2025-05-06
Annual Report 0006241751 2025-05-06
Initial Filing 0005733441 2024-05-09

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Date of last update: 12 Jul 2025

Sources: Idaho Secretary of State