Canyon Grove LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CANYON GROVE LLC

Doing business as

Angel Care

Practice address

4301 31St St S
St Petersburg, FL 33712-4053

Phone

(727) 867-1300

NPI assigned

Feb 18, 2019

Last updated

Mar 29, 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

Shlomo Greenstein

Title

Member

Phone

(718) 256-1905

Specialties & licenses 1

Addresses

Other names 1

• Angel Care Doing business as

Locations

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1396201141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 60TH ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042633",
            "telephone_number": "718-256-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 31ST ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337124053",
            "telephone_number": "727-867-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "GREENSTEIN",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-256-1905"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Angel Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Irma Cankusic, MS
• Judith Cann-Trump
• Kathrina Cann, LMHC
• Rachael Katherine Cano
• Robert Cantor
• Mitchell James Capelli
• Alicia P Capen, MS, CCC-SLP
• Shanna Lea Gustafson Capen, M.S., M.P.H, C.G.C.
• Marjorie Capers, LCSW
• Marsha Capinpin, PTA

• Assisted Living Facility in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.