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GRASSROOTS THERAPY GROUP, LLC

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Company Details

Legal Name: GRASSROOTS THERAPY GROUP, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: June 1st 2013
Expiration date: 30 Jun 2026
UBI Number: 603 304 875
ZIP code: 99201
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1212 N WASHINGTON ST #204, SPOKANE, WA, 99201, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 6310 S MADELIA ST, SPOKANE, SPOKANE, WA, 99223-8355, UNITED STATES

Contact Details

E-Mail: JILSON@COMCAST.NET
Phone Number: +1 509-448-8818

Nature of Business

Health Care, Social Assistance & Service Organization, Professional, Scientific & Technical Services

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Registered Agent Information

Name Role Address
JOANN JILSON Registered Agent 6310 S MADELIA ST, SPOKANE, WA, 99223-0000, UNITED STATES

Key Officers & Management

Name Role Address
SANDRA GORMON-BROWN Governing Person 1008 E WINDEMERE CT, SPOKANE, WA, 99223-6228, UNITED STATES
LORI EASTEP Governing Person 5412 A MADELIA ST, SPOKANE, WA, 99223, UNITED STATES

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
LORI EASTEP
Last Update Date:
2024-09-23
Naics Primary:
621330

Self-Certification:

Self-Certified Small Disadvantaged Business
For Profit Organization
Women-Owned Small Business
Woman-Owned Business
Limited Liability Company

Unique Entity ID

Unique Entity ID:
FV6RHACLPHJ9
CAGE Code:
02L82
UEI Expiration Date:
2025-09-17

Business Information

Activation Date:
2024-09-19
Initial Registration Date:
2024-09-17

National Provider Identifier

NPI Number:
1215379086
Certification Date:
2024-11-20

Authorized Person:

Name:
LORI EASTEP
Role:
PARTNER/THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
No
Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
No
Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
5092672717
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