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Canvi Behavioral Health, PLLC

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Company Details

Name: Canvi Behavioral Health, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 Oct 2021 (4 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 4442287
Place of Formation: IDAHO
File Number: 785556
ZIP code: 83202
County: Bannock County
Principal Address: STE 3B 4650 HAWTHORNE ROAD CHUBBUCK, ID 83202
Mailing Address: JENNIFER HUNSAKER 3162 N 700 E NORTH OGDEN, UT 84414-1671

Agent

Name Role Address
Jennifer Hunsaker Agent 1790 N ELK ROAD, POCATELLO, ID 83204

Member

Name Role Address Appointed On
Hunsaker Management Group, LLC Member 3162 N 700 E, NORTH OGDEN, UT 84414 2021-11-30

National Provider Identifier

NPI Number:
1164179438
Certification Date:
2022-03-07

Authorized Person:

Name:
KRISTA BATTS
Role:
CONTRACTING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
251B00000X - Case Management Agency
Is Primary:
No
Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Fax:
2086484167

Filing

Filing Name Filing Number Filing date
Annual Report 0005878897 2024-09-03
Annual Report 0005381404 2023-09-05
Annual Report 0004884490 2022-09-06
Amendment to Certificate 0004626991 2022-03-01
Amendment to Certificate 0004508334 2021-11-30

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Date of last update: 09 Jul 2025

Sources: Idaho Secretary of State