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  5. MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC

MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC

Company Details

Name: MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Nov 2002 (22 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 78106
Place of Formation: IDAHO
File Number: 78106
ZIP code: 83221
County: Bingham County
Principal Address: 98 POPLAR ST BLACKFOOT, ID 83221
Mailing Address: JAKE ERICKSON 350 N MERIDIAN ST BLACKFOOT, ID 83221-1625

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2023 470917144 2024-09-03 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2024-09-03
Name of individual signing JAKE ERICKSON
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2022 470917144 2023-09-07 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2023-09-07
Name of individual signing JAKE ERICKSON
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2021 470917144 2022-10-11 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing JAKE ERICKSON
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2020 470917144 2021-10-14 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing JAKE ERICKSON
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2019 470917144 2020-10-12 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2020-10-12
Name of individual signing JEFF DANIELS
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2018 470917144 2019-07-03 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2019-07-03
Name of individual signing JEFF DANIELS
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2017 470917144 2018-06-18 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2018-06-18
Name of individual signing JEFF DANIELS
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2016 470917144 2017-09-05 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2017-09-05
Name of individual signing JEFF DANIELS
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2015 470917144 2016-10-05 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2016-10-05
Name of individual signing JEFF DANIELS
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC RETIREMENT PLAN 2014 470917144 2015-09-23 MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-01
Business code 622000
Sponsor’s telephone number 2087854100
Plan sponsor’s address 98 POPLAR, BLACKFOOT, ID, 83221

Plan administrator’s name and address
Administrator’s EIN 470917144
Plan administrator’s name MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Plan administrator’s address 98 POPLAR, BLACKFOOT, ID, 83221
Administrator’s telephone number 2087854100

Signature of
Role Plan administrator
Date 2015-09-23
Name of individual signing JEFF DANIELS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JAKE ERICKSON Agent 98 POPLAR ST, BLACKFOOT, ID 83221

Manager

Name Role Address Appointed On
Jake Erickson Manager 98 POPLAR ST, BLACKFOOT, ID 83221 2020-12-02

Filing

Filing Name Filing Number Filing date
Annual Report 0005932910 2024-10-08
Annual Report 0005440392 2023-10-13
Annual Report 0004972614 2022-11-03
Annual Report 0004475300 2021-11-02
Annual Report 0004082414 2020-12-02
Annual Report 0003636983 2019-10-02
Annual Report 0003343656 2018-11-05
Statement of Change of Business Mailing Address 0003341706 2018-11-01
Change of Registered Office/Agent/Both (by Entity) 0001210353 2017-12-07
Annual Report 0001210352 2017-09-29

Related by officers

JAKE ERICKSON

CRESTWOOD ENTERPRISES, LLC CMRGO, LLC IDAHO PHYSICIANS CLINIC, LLC IDAHO PAIN TREATMENT CENTER, LLC HEALTH & WELLNESS SLEEP INSTITUTE OF POCATELLO, LLC DOCTORS AND HOSPITAL HEALTH SYSTEM OF IDAHO, LLC BINGHAM LAND, LLC BMH PHYSICIANS CLINIC, LLC IDAHO QUALITY ADVOCATES, LLC PIETRA, L.C.

Jake Erickson

IDAHO HOSPITAL ASSOCIATION, INCORPORATED IDAHO PHYSICIANS CLINIC, LLC HEALTH & WELLNESS SLEEP INSTITUTE OF POCATELLO, LLC BMH PHYSICIANS CLINIC, LLC BINGHAM COMMUNITY HEALTH PLAN, INC. BINGHAM HEALTH CARE FOUNDATION, INC (THE) HEALTH & WELLNESS SLEEP INSTITUTE, PLLC (THE) BMH, INC. NDBWFEA LLC Community Healthcare Alliance LLC

Related by address

98 POPLAR ST BLACKFOOT, ID 83221

POCATELLO WOMEN'S HEALTH CLINIC CMRGO, LLC IDAHO PAIN TREATMENT CENTER, LLC HEALTH & WELLNESS SLEEP INSTITUTE OF POCATELLO, LLC BLACKFOOT MEDICAL CENTER, LLC IDAHO PHYSICIANS CLINIC, LLC DOCTORS AND HOSPITAL HEALTH SYSTEM OF IDAHO, LLC BINGHAM LAND, LLC BMH PHYSICIANS CLINIC, LLC

Date of last update: 14 Jan 2025

Sources: Idaho Secretary of State

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