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Hazel Healthcare LLC

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Company Details

Name: Hazel Healthcare LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 13 Sep 2023 (2 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 5400224
Place of Formation: IDAHO
File Number: 898047
ZIP code: 83646
County: Ada County
Principal Address: 2584 N STOKESBERRY PL MERIDIAN, ID 83646-1144

Agent

Name Role Address
Eva Bingham Agent 4422 SOUTH ALEUT WAY, BOISE, ID 83709

Managing Member

Name Role Address Appointed On
Eva Bingham Managing Member 4422 SOUTH ALEUT WAY, BOISE, ID 83709 2024-10-02

National Provider Identifier

NPI Number:
1962266403
Certification Date:
2024-02-06

Authorized Person:

Name:
LAURA D CARTER
Role:
CO-OWNER/ CLINICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005917623 2024-10-02
Statement of Change of Business Mailing Address 0005491145 2023-11-20
Initial Filing 0005400224 2023-09-13

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Date of last update: 20 Jun 2025

Sources: Idaho Secretary of State