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MOUNTAIN WEST SUPPORTIVE SERVICES, LLC

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Company Details

Name: MOUNTAIN WEST SUPPORTIVE SERVICES, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 22 Jan 2018 (7 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 589890
Place of Formation: IDAHO
File Number: 589890
ZIP code: 83404
County: Bonneville County
Principal Address: KALLE SMITH STE 208 1970 E 17TH ST IDAHO FALLS, ID 83404-8048

Agent

Name Role Address
JEREMY WESTWOOD Agent 170 N HOLMES AVE, JEREMY WESTWOOD, IDAHO FALLS, ID 83401

Member

Name Role Address Appointed On
Kalle Smith Member 4226 POCONO ST, IDAHO FALLS, ID 83404 2021-02-12

National Provider Identifier

NPI Number:
1114417029

Authorized Person:

Name:
KALLE STEPHANIE SMITH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
251B00000X - Case Management Agency
Is Primary:
No
Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
2087150210

Filing

Filing Name Filing Number Filing date
Annual Report 0006127407 2025-02-25
Application for Reinstatement 0005603156 2024-02-14
Dissolution/Revocation - Administrative 0005197588 2023-04-13
Annual Report 0004554068 2022-01-04
Annual Report 0004173670 2021-02-12

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Date of last update: 15 May 2025

Sources: Idaho Secretary of State