Canyon Creek Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

2015-HHA-75037 Issued in UT

Legal business name

CANYON CREEK HOME HEALTH CARE LLC

Doing business as

Premier Home Health Utah

Practice address

3443 S State St Ste 9
South Salt Lake, UT 84115-4914

Phone

(801) 251-1595

Fax

(801) 251-1599

NPI assigned

May 19, 2006

Last updated

Apr 17, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Cosby, HFA

Title

Owner

Phone

(801) 251-1595

Specialties & licenses 5

Addresses

Other names 1

• Premier Home Health Utah Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1174577753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 S STATE ST STE 9",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154914",
            "telephone_number": "801-251-1595",
            "fax_number": "801-251-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 S STATE ST STE 9",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841154914",
            "telephone_number": "801-251-1595",
            "fax_number": "801-251-1599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2964 W 4700 S",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Taylorsville",
            "state": "UT",
            "postal_code": "841292557",
            "country_code": "US",
            "telephone_number": "801-251-1595",
            "fax_number": "801-251-1599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANYON CREEK HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "COSBY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-251-1595",
        "authorized_official_credential": "HFA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "2006-HHA-75037",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "2011-HHA-75037",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "2013-HHA-75037",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "2015-HHA-75037",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Home Health Utah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Home Health Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devon Byrne
• Cindy Rae Campbell
• Scott L Campbell, MSW, CSW
• Jackie Candilora, BSN, RN
• Olimpia Canizal, CPSS
• Ennio D Cardozo, CPSS
• Careatc
• Ieesha Carroll
• Maria P Cascavita Aranguren, LCSW
• Ruth C Castaneda, CPSS

• Home Health Agency in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Home Health Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.