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Haven Health Services, LLC

Company Details

Name: Haven Health Services, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 22 Mar 2025 (2 months ago)
Financial Date End: 31 Mar 2026
Entity Number: 6168101
Place of Formation: IDAHO
File Number: 984713
ZIP code: 83301
County: Twin Falls County
Principal Address: 433 TYLER STREET TWIN FALLS, ID 83301
Mailing Address: 433 TYLER ST TWIN FALLS, ID 83301-3956

Agent

Name Role Address
Cedric Mukulu Agent 433 TYLER ST, TWIN FALLS, ID 83301-3956

National Provider Identifier

NPI Number:
1972307254
Certification Date:
2025-04-07

Authorized Person:

Name:
CEDRIC MUKULU
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No
Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0006168101 2025-03-22

Date of last update: 01 May 2025

Sources: Idaho Secretary of State