Search icon

LIFE CHANGE ASSOCIATES, PC

Company claim

Is this your business?

Get access!

Company Details

Name: LIFE CHANGE ASSOCIATES, PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 27 Sep 2013 (12 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 602614
Place of Formation: IDAHO
File Number: 602614
ZIP code: 83204
County: Power County
Mailing Address: 2520 S 5TH AVE POCATELLO, ID 83204-1923

Agent

Name Role Address
STEVEN MCKEE Agent 14801 KENSINGTON LN, CHUBBUCK, ID 83202

President

Name Role Address Appointed On Resigned On
Deric V Ravsten President 2702 BIRDIE THOMPSON DR, POCATELLO, ID 83201 2020-08-07 2023-08-08

Director

Name Role Address Appointed On
Steven McKee Director 2520 S. 5TH AVE, POCATELLO, ID 83204 2024-09-04

National Provider Identifier

NPI Number:
1598077562

Authorized Person:

Name:
DR. DERIC V RAVSTEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
8772842783

Filing

Filing Name Filing Number Filing date
Annual Report 0005881087 2024-09-04
Change of Registered Office/Agent/Both (by Entity) 0005782050 2024-06-17
Articles of Amendment 0005757639 2024-06-03
Annual Report 0005357373 2023-08-08
Annual Report 0004838432 2022-08-03

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 05 Jul 2025

Sources: Idaho Secretary of State