Organization Active NPI

Sun Valley Specialty Healthcare, Inc

  • Pediatric Skilled Nursing Facility
  • Sun Valley, CA
National Provider Identifier
1285049619
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
Legal business name
SUN VALLEY SPECIALTY HEALTHCARE, INC
Practice address
10716 La Tuna Canyon Rd
Sun Valley, CA 91352-2130
Phone
(818) 252-5863
Fax
(818) 683-1853
NPI assigned
Jun 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Robert D Nydam
Title
Owner
Phone
(818) 252-5863

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X Primary

Addresses

Primary practice location

10716 La Tuna Canyon Rd
Sun Valley, CA 91352-2130

Mailing address

10716 La Tuna Canyon Rd
Sun Valley, CA 91352-2130
Phone (818) 252-5863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141028002267 CA Part A Provider - Skilled Nursing Facility 7810118288 Practice locations: Sun Valley, CA

Skilled nursing facility certification: CCN 555815

Legal name
SUN VALLEY SPECIALTY HEALTHCARE INC
Doing business as
TOTALLY KIDS SPECIALTY HEALTHCARE SUN VALLEY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 12, 2004
Last certification
Dec 29, 2024
Beds
45
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
May 23, 2013
Enrollment address
10716 La Tuna Canyon Rd
Sun Valley, CA 91352-2130
Nursing home name
TOTALLY KIDS SPECIALTY HEALTHCARE - SUN VALLEY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Totally Kids Specialty Healthcare - Sun ValleyCCN 555815 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 12, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4536.9 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert Nydam Individual 5% Or Greater Direct Ownership Interest May 23, 2013 48%
Corporate OfficerBoard President May 23, 2013 48%
Corporate DirectorBoard President May 23, 2013 48%
W-2 Managing EmployeeBoard President May 23, 2013 48%
Michelle Nydam Individual 5% Or Greater Direct Ownership InterestCeo May 23, 2013 48%
Corporate OfficerCeo May 23, 2013 48%
Corporate DirectorCeo May 23, 2013 48%
W-2 Managing EmployeeCeo May 23, 2013 48%

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1285049619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10716 LA TUNA CANYON RD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913522130",
            "telephone_number": "818-252-5863",
            "fax_number": "818-683-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10716 LA TUNA CANYON RD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913522130",
            "telephone_number": "818-252-5863",
            "fax_number": "818-683-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY SPECIALTY HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "NYDAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-252-5863"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Valley, CA

Sources for this page

Verify at the official NPI Registry.