Search icon

Canyon Primary Care LLC

Company claim

Is this your business?

Get access!

Company Details

Name: Canyon Primary Care LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 16 Jan 2024 (2 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 5563255
Place of Formation: IDAHO
File Number: 916369
ZIP code: 83301
County: Twin Falls County
Principal Address: HAILEE LI FNP-BC 1215 CHENEY DR W # W TWIN FALLS, ID 83301
Mailing Address: HAILEE LI FNP 2657 E 3700 N TWIN FALLS, ID 83301-0146

Agent

Name Role Address
Hailee Li Agent 1215 CHENEY DR #W, HAILEE LI, TWIN FALLS, ID 83301

Manager

Name Role Address Appointed On
Hailee Li Manager 1215 CHENEY DR #W, TWIN FALLS, ID 83301 2025-01-05

National Provider Identifier

NPI Number:
1538921630
Certification Date:
2025-07-04

Authorized Person:

Name:
HAILEE LI
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
9496954627

Filing

Filing Name Filing Number Filing date
Statement of Change of Business Mailing Address 0006287093 2025-05-29
Annual Report 0006048863 2025-01-05
Initial Filing 0005563255 2024-01-16

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 26 Jul 2025

Sources: Idaho Secretary of State