| Name: | ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC. |
| Jurisdiction: | Idaho |
| Legal type: | Foreign Nonprofit Corporation |
| Status: | Active-Good Standing |
| Date of registration: | 06 Sep 2017 (7 years ago) |
| Financial Date End: | 30 Sep 2025 |
| Entity Number: | 632590 |
| Place of Formation: | CALIFORNIA |
| File Number: | 632590 |
| Principal Address: | 2100 DOUGLAS BLVD ROSEVILLE, CA 95661 |
| Mailing Address: | 15630 18TH AVE CLEARLAKE, CA 95422-9336 |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 1305 12TH AVE RD, NAMPA, ID 83686 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| David Santos | President | 15630 18TH AVE, CLEARLAKE, CA 95422 | 2020-09-28 | 2022-08-09 |
| Colleen Assavapisitkul | President | 15630 18TH AVE, CLEARLAKE, CA 95422-9336 | 2023-09-04 | 2024-05-14 |
| Eric Stevens | President | 15630 18TH AVE, CLEARLAKE, CA 95422-9336 | 2024-08-02 | No data |
| Judson Howe | President | 15630 18TH AVE, CLEARLAKE, CA 95422-9336 | 2024-05-14 | No data |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| MEREDITH JOBE | Secretary | ONE ADVENTIST HEALTH WAY, ROSEVILLE, CA 95661 | 2022-08-09 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| Dean Shepardson | Treasurer | 15630 18TH AVE, CLEARLAKE, CA 95422-9336 | 2023-09-04 | 2023-10-02 |
| Jeff Mock | Treasurer | 15630 18TH AVE, CLEARLAKE, CA 95422-9336 | 2023-10-02 | No data |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Annual Report | 0005836448 | 2024-08-02 |
| Annual Report Amendment | 0005737517 | 2024-05-14 |
| Annual Report Amendment | 0005416286 | 2023-10-02 |
| Annual Report | 0005381101 | 2023-09-04 |
| Annual Report Amendment | 0005186302 | 2023-04-07 |
| Annual Report Amendment | 0005072781 | 2023-01-17 |
| Annual Report Amendment | 0004925174 | 2022-09-26 |
| Annual Report | 0004854027 | 2022-08-09 |
| Registered Agent Name/Address Change (mass change) | 0004645828 | 2022-03-08 |
| Registered Agent Name/Address Change (mass change) | 0004471285 | 2021-10-29 |
Date of last update: 29 Dec 2024
Sources: Idaho Secretary of State
