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Russet Ridge Healthcare LLC

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Company Details

Name: Russet Ridge Healthcare LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 23 May 2025 (a month ago)
Financial Date End: 31 May 2026
Entity Number: 6264045
Place of Formation: NEVADA
File Number: 995603
ZIP code: 83704
County: Ada County
Principal Address: 1140 N. ALLUMBAUGH ST BOISE, ID 83704
Mailing Address: STE 127 29222 RANCHO VIEJO RD SAN JUAN CAPISTRANO, CA 92675-1049

Agent

Name Role Address
COGENCY GLOBAL INC. Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

National Provider Identifier

NPI Number:
1558154492
Certification Date:
2025-05-23

Authorized Person:

Name:
SOON BURNAM
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
2088548665

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006266783 2025-05-27
Initial Filing 0006264045 2025-05-23

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Date of last update: 01 Jun 2025

Sources: Idaho Secretary of State