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PICU ASSOCIATES, LLC

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Company Details

Name: PICU ASSOCIATES, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 18 Jun 2002 (23 years ago)
Financial Date End: 30 Jun 2023
Date dissolved: 02 Jun 2023
Entity Number: 72691
Place of Formation: IDAHO
File Number: 72691
ZIP code: 83712
County: Ada County
Principal Address: 190 E. BANNOCK ST BOISE, ID 83712
Mailing Address: PO BOX 678 NEW MEADOWS, ID 83654-0678

Agent

Name Role Address
Paul Jansen Agent 190 E BANNOCK ST, BOISE, ID 83712

Manager

Name Role Address Appointed On
Paul W Jansen Manager PO BOX 678, NEW MEADOWS, ID 83654 2022-05-03

Member

Name Role Address Appointed On
David W Christensen Member PO BOX 170320, BOISE, ID 83717 2021-05-03

National Provider Identifier

NPI Number:
1073608378

Authorized Person:

Name:
PAUL W JANSEN
Role:
OWNER/PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
2080P0203X - Pediatric Critical Care Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5302415377

Form 5500 Series

Employer Identification Number (EIN):
743052404
Plan Year:
2022
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
2
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0005248542 2023-06-02
Annual Report 0004727535 2022-05-03
Annual Report 0004268006 2021-05-04
Amendment to Certificate 0004264816 2021-05-03
Change of Registered Office/Agent/Both (by Entity) 0004247163 2021-04-15

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Date of last update: 26 May 2025

Sources: Idaho Secretary of State