Organization
HAVEN HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC MUKULU (OWNER)
(208) 280-3508
Entity
Organization
Contact information
Practice address
433 TYLER ST, TWIN FALLS, ID 83301-3956
(208) 280-3508
Mailing address
433 TYLER ST, TWIN FALLS, ID 83301-3956
(208) 280-3508
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/07/2025
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