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FERN LANE COMPANY, LLC

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Company Details

Legal Name: FERN LANE COMPANY, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: March 22nd 2017
Expiration date: 31 Mar 2026
UBI Number: 604 106 544
ZIP code: 98257
City: La Conner
County: SKAGIT
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 708 E MORRIS ST, STE B, LA CONNER, WA, 98257, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 2104, LA CONNER, WA, 98257-2104, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $128

Contact Details

E-Mail: THRIVEDIRECTHEALTHCARE@GMAIL.COM
Phone Number: +1 360-630-5141

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
brianna wilson Registered Agent 708 e morris st ste b, LA CONNER, WA, 98257, UNITED STATES

Key Officers & Management

Name Role
BRIANNA WILSON Governing Person
KEVIN WILSON Governing Person

National Provider Identifier

NPI Number:
1497255293
Certification Date:
2020-01-15

Authorized Person:

Name:
DR. BRIANNA WILSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP3300X - Pain Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8663027491

Form 5500 Series

Employer Identification Number (EIN):
825310244
Plan Year:
2024
Number Of Participants:
3
Plan Name:
401(K)
Sponsor's telephone number:
Plan Administrator / Signatory:
QIAN LIU(Plan administrator)

History

Type Old value New value Date of change
Name change THRIVE DIRECT HEALTH CARE, INC. FERN LANE COMPANY, LLC 2021-08-30
Name change FERN LANE COMPANY, LLC THRIVE DIRECT HEALTH CARE, INC. 2021-05-20
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