NPIMap

Organization Active NPI

Care at Home, Inc.

Doing business as Canyon Home Care & Hospice

  • Home Health Agency
  • Fruitland, ID
National Provider Identifier
1831135474
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH-112 Issued in ID
Legal business name
CARE AT HOME, INC.
Doing business as
Canyon Home Care & Hospice
Practice address
929 NW 16TH St
Fruitland, ID 83619-2256
Phone
(208) 642-1838
Fax
(888) 572-2145
NPI assigned
Jun 21, 2006
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Breezie Liskey
Title
VP of Operations
Phone
(801) 456-7874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH-112 ID Primary

Addresses

Primary practice location

929 NW 16TH St
Fruitland, ID 83619-2256

Mailing address

746 E Winchester St Ste 200
Salt Lake City, UT 84107-8513
Phone (801) 485-6166

Other practice location 1

2440 S Titanium Pl
Meridian, ID 83642-6703
Phone (208) 453-2659

Other names 1

  • Canyon Home Care & Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090126000312 ID Part A Provider - Home Health Agency 8527122266 Practice locations: Fruitland, ID; Meridian, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831135474. Details of each certification follow.

Home health agency certification: CCN 137068

Legal name
CARE AT HOME, INC
Doing business as
CANYON HOME CARE & HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 21, 1993
Last certification
Dec 10, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 13, 2004 in ID
Enrollment address
929 NW 16TH St
Fruitland, ID 83619-2256
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Canyon Home Care & HospiceCCN 137068 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Dec 21, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

501 N 16th St
Ste 112
Payette, ID 83661
Phone (208) 642-1838

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Kenneth Edwin Norris Individual 5% Or Greater Indirect Ownership InterestManaging Partner Dec 1, 2016 50%
Corporate Officer Dec 1, 2016 100%
Operational/Managerial ControlManaging Partner Dec 1, 2016 100%
Tyson Cichos Individual 5% Or Greater Indirect Ownership Interest Dec 11, 2016 25%
Cory R Robison Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2016 25%
Matthew Marakis Individual W-2 Managing EmployeeBranch Manager Nov 11, 2024 100%
Canyon Idaho Home Care & Hospice LLC Organization, Salt Lake City, UT Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Dec 1, 2016 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 24

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1831135474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 E WINCHESTER ST STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078513",
            "telephone_number": "801-485-6166",
            "fax_number": "801-531-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 NW 16TH ST",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192256",
            "telephone_number": "208-642-1838",
            "fax_number": "888-572-2145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2440 S Titanium Pl",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426703",
            "country_code": "US",
            "telephone_number": "208-453-2659",
            "fax_number": "208-454-0854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARE AT HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "LISKEY",
        "authorized_official_first_name": "BREEZIE",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "801-456-7874"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ID",
            "license": "HH-112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Canyon Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fruitland, ID

Sources for this page

Verify at the official NPI Registry.