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Open Space Mental Health LLC

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Company Details

Name: Open Space Mental Health LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 12 Dec 2024 (8 months ago)
Financial Date End: 31 Dec 2025
Entity Number: 6020981
Place of Formation: WYOMING
File Number: 967625
Principal Address: 3625 CHENEY LANE WILSON, WY 83014
Mailing Address: BEN RAE PO BOX 955 WILSON, WY 83014

Agent

Name Role Address
Ben Rae Agent 3330 RINGNECK DRIVE, IDAHO FALLS, ID 83401

National Provider Identifier

NPI Number:
1235947524
Certification Date:
2024-12-19

Authorized Person:

Name:
MR. BENJAMIN G RAE IV
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0006020981 2024-12-12

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Date of last update: 27 Jul 2025

Sources: Idaho Secretary of State