| Name: | Odyssey Family Practice llc |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 18 Dec 2018 (6 years ago) |
| Entity Number: | 10096427 |
| ZIP code: | 99611 |
| County: | Kenai Peninsula |
| Place of Formation: | ALASKA |
| Address: | 11595 KENAI SPUR HIGHWAY, KENAI, AK 99611 |
Line of Business
62 Health Care and Social AssistanceNAICS
621399 OFFICES OF ALL OTHER MISCELLANEOUS HEALTH PRACTITIONERS| Name | Role |
|---|---|
| Jared Wallace | Member |
| Rhiannon Wallace | Member |
| Jared Wallace | Registered Agent |
| Plan Name | Plan Year | EIN/PN | Received | Total number of participants | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ODYSSEY FAMILY PRACTICE LLC 401K | 2023 | 832872716 | 2024-09-12 | 14 | |||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-09-12 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 1107781 | Business License | Active | 2018-12-26 | 2023-10-16 | 2025-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621399 - OFFICES OF ALL OTHER MISCELLANEOUS HEALTH PRACTITIONERS |
| License Number | Program | Type | Status | Issue Date | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|
| 146104 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2019-04-26 | 2019-04-26 | - |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 346018443 | 1050210 | 2022-06-13 | 11595 KENAI SPUR HIGHWAY, KENAI, AK, 99611 | |||||||||||
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Date of last update: 24 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
