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Confluence Functional & Integrative Psychiatry LLC

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Company Details

Name: Confluence Functional & Integrative Psychiatry LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 17 Jul 2023 (2 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 5328698
Place of Formation: IDAHO
File Number: 889693
ZIP code: 83714
County: Ada County
Principal Address: 8989 W SLOAN ST BOISE, ID 83714
Mailing Address: STE 107 1015 W HAYS ST BOISE, ID 83702-5412

Agent

Name Role Address
TROY HENDRICKSON Agent 8989 W SLOAN ST, BOISE, ID 83714

Manager

Name Role Address Appointed On
TROY HENDRICKSON Manager 8989 W SLOAN ST, GARDEN CITY, ID 83714 2024-09-30

National Provider Identifier

NPI Number:
1881375483
Certification Date:
2023-09-05

Authorized Person:

Name:
KRYSTAL DEMONEY-HENDRICKSON
Role:
FOUNDER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
8885516190

Filing

Filing Name Filing Number Filing date
Annual Report 0005915434 2024-09-30
Statement of Change of Business Mailing Address 0005597091 2024-02-10
Initial Filing 0005328698 2023-07-17

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Date of last update: 20 Jun 2025

Sources: Idaho Secretary of State