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Evergreen Wellness, LLC

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Company Details

Name: Evergreen Wellness, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 03 Jan 2025 (6 months ago)
Financial Date End: 31 Jan 2026
Entity Number: 6047112
Place of Formation: IDAHO
File Number: 970758
ZIP code: 83810
County: Kootenai County
Principal Address: 24447 EAST DOYLE ROAD CATALDO, ID 83810
Mailing Address: 24447 E DOYLE RD CATALDO, ID 83810-9467

Agent

Name Role Address
Kevin Johnson Agent 24447 EAST DOYLE ROAD, CATALDO, ID 83810

National Provider Identifier

NPI Number:
1669283545
Certification Date:
2025-01-18

Authorized Person:

Name:
MEGHANN JOHNSON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0006047112 2025-01-03

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Date of last update: 22 Jun 2025

Sources: Idaho Secretary of State