Canyon Home III

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

License

960001061 Issued in CA

Legal business name

CANYON HOME III

Doing business as

Canyon Homes Inc

Practice address

10712 Artrude St
Shadow Hills, CA 91040-1314

Phone

(818) 353-1514

NPI assigned

Jan 24, 2007

Last updated

Apr 8, 2024By 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

Mr. Richard W. Denogean, RN

Title

Ceo

Phone

(818) 353-8214

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Canyon Homes Inc Doing business as

Tax ID family

Canyon Home II2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Canyon Home II

  dba Canyon Homes Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Sunland, CA
  • NPI 1013063841
  NPD tax ID

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1669527941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10712 ARTRUDE ST",
            "city": "SHADOW HILLS",
            "state": "CA",
            "postal_code": "910401314",
            "telephone_number": "818-353-8214",
            "fax_number": "818-273-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10712 ARTRUDE ST",
            "city": "SHADOW HILLS",
            "state": "CA",
            "postal_code": "910401314",
            "telephone_number": "818-353-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON HOME III",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "DENOGEAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-353-8214",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "CA",
            "license": "960001061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60886F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Homes Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deven Adams
• Ananda Inc. (Ananda Treatment Behavioral Health and Wellness Center)
• Katherine Denogean
• Inner Harmony Therapy, a Professional Licensed Clinical Social Worker Corporation (Inner Harmony Therapy)
• Island Garden Assisted Living
• Bonnie Fraser Lemus, NP
• Maslow Najera Inc.

• Mental Illness Intermediate Care Facility in Shadow Hills, CA
• Providers in Shadow Hills, CA by specialty
• Mental Illness Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.