Organization
CANYON HOME II
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
8611 WENTWORTH, SUNLAND, CA 91040
(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
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
960001001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60809F
—
CA
Enumeration date
01/26/2007
Last updated
04/08/2024
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