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ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC.

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Company Details

Name: ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC.
Jurisdiction: Idaho
Legal type: Foreign Nonprofit Corporation
Status: Active-Good Standing
Date of registration: 06 Sep 2017 (8 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

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

President

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

Secretary

Name Role Address Appointed On
MEREDITH JOBE Secretary ONE ADVENTIST HEALTH WAY, ROSEVILLE, CA 95661 2022-08-09

Treasurer

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

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

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Date of last update: 16 May 2025

Sources: Idaho Secretary of State