# INDIAN CANYON PACC, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Indian Canyon Post Acute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760118962
- **Authorized official:** STEVEN R POWELL (PRESIDENT/MEMBER)
- **Authorized official phone:** (909) 795-2421

## Contact information

- **Practice address:** 57333 JOSHUA LN, YUCCA VALLEY, CA 92284-4124
- **Practice address phone:** (760) 853-4750
- **Mailing address:** 57333 JOSHUA LN, YUCCA VALLEY, CA 92284-4124
- **Mailing address phone:** (951) 977-0777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2022
- **Last updated:** 02/16/2023