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Mountain Country Family Healthcare, PLLC

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Company Details

Name: Mountain Country Family Healthcare, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 02 Aug 2018 (7 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 621488
Place of Formation: IDAHO
File Number: 621488
ZIP code: 83869
County: Kootenai County
Principal Address: PO BOX 1671 SPIRIT LAKE, ID 83869
Mailing Address: PO BOX 1671 SPIRIT LAKE, ID 83869-1605

Agent

Name Role Address
LANA YOUNG ARNP-C Agent 105 GRACE ROCK RD, PRIEST RIVER, ID 83856

Manager

Name Role Address Appointed On Resigned On
Lana R Young Manager 31911 N. 5TH AVE, SPIRIT LAKE, ID 83869 2020-08-27 2022-08-07
Lana Young Manager 31848 N 4TH AVE., SPIRIT LAKE, ID 83869 2022-08-07 No data

National Provider Identifier

NPI Number:
1447801451

Authorized Person:

Name:
LANA ROCHELLE YOUNG
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005905147 2024-09-19
Annual Report 0005404979 2023-09-18
Application for Reinstatement 0004851537 2022-08-07
Dissolution/Revocation - Administrative 0004489411 2021-11-06
Annual Report 0003981083 2020-08-27

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Date of last update: 05 Jul 2025

Sources: Idaho Secretary of State