CANYON HOME III NPI 1669527941

NPI Information

  • NPI: 1669527941
  • Provider Name: CANYON HOME III
  • Classification: Intermediate Care Facility, Mental Illness - 310500000X
  • Entity Type: Organization
  • Doing Business As: CANYON HOMES INC
  • Address: 10712 ARTRUDE ST
    SHADOW HILLS, CA
    ZIP 91040
  • Phone: (818) 353-1514

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NPI Details

CANYON HOME III is an intermediate care facility mental illness in Shadow Hills, CA. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. CANYON HOME III NPI is 1669527941. The provider is registered as an organization entity type.
The provider Is Doing Business As Canyon Homes Inc.

The provider's business location address is:

10712 ARTRUDE ST
SHADOW HILLS, CA
ZIP 91040-314
Phone: (818) 353-1514

The provider's authorized official is Richard W. Denogean .
The authorized official title is Ceo and has the following contact phone number (818) 353-8214.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 4/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310500000XIntermediate Care Facility, Mental Illness960001061CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1LTC60886FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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