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Organization
CANYON HOME III
Active
Organization
CANYON HOME III
Active
Other names
Canyon Homes Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD W. DENOGEAN RN (CEO)
(818) 353-8214
Entity
Organization
Contact information
Practice address
10712 ARTRUDE ST, SHADOW HILLS, CA 91040-1314
(818) 353-1514
Mailing address
10712 ARTRUDE ST, SHADOW HILLS, CA 91040-1314
(818) 353-8214
(818) 273-4479
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
960001061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60886F
—
CA
Enumeration date
01/24/2007
Last updated
04/08/2024
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