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FUNCTIONAL MEDICINE CENTER OF BOISE LLC

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Company Details

Name: FUNCTIONAL MEDICINE CENTER OF BOISE LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Domesticated Out
Date of registration: 26 Mar 2018 (7 years ago)
Financial Date End: 31 Mar 2025
Date dissolved: 21 Feb 2025
Entity Number: 601003
Place of Formation: IDAHO
File Number: 601003
ZIP code: 83687
County: Canyon County
Principal Address: 3808 WHISTLING HEIGHTS WAY NAMPA, ID 83687
Mailing Address: SPENCER ZIMMERMAN STE 100 1678 S WOODSAGE AVE MERIDIAN, ID 83642-8325

Agent

Name Role Address
SPENCER ZIMMERMAN Agent 1678 S WOODSAGE AVE, 100, SPENCER ZIMMERMAN, MERIDIAN, ID 83642

Manager

Name Role Address Appointed On
Spencer Zimmerman Manager 1055 S TWIN LAKES AVENUE, MIDDLETON, ID 83644 2021-06-15

National Provider Identifier

NPI Number:
1710477310

Authorized Person:

Name:
SPENCER ZIMMERMAN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Statement of Domestication Out 0006105230 2025-02-21
Annual Report 0005683894 2024-04-08
Annual Report 0005192593 2023-04-09
Annual Report 0004695266 2022-04-12
Dissolution/Revocation - Administrative 0004316091 2021-06-15

USAspending Awards / Financial Assistance

Date:
2020-05-04
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
15461.00
Total Face Value Of Loan:
15461.00

Paycheck Protection Program

Date Approved:
2020-05-04
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
15461
Current Approval Amount:
15461
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
15635.94

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Date of last update: 15 May 2025

Sources: Idaho Secretary of State