Copper Canyon Senior Care Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COPPER CANYON SENIOR CARE INC

Doing business as

COPPER CANYON SENIOR CARE INC

Practice address

37225 Jerome LN
Murrieta, CA 92562-3255

Phone

(951) 966-5385

Fax

(951) 696-5875

NPI assigned

May 14, 2021

Organization subpart

No

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

Authorized official

Name

Telecia Cooke

Title

Ceo

Phone

(951) 966-5385

Specialties & licenses 1

Addresses

Other names 2

• COPPER CANYON SENIOR CARE INC Doing business as
• Aging Well Home Care Former legal business name

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1841864816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37225 JEROME LN",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925623255",
            "telephone_number": "951-966-5385",
            "fax_number": "951-696-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37225 JEROME LN",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925623255",
            "telephone_number": "951-966-5385",
            "fax_number": "951-696-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER CANYON SENIOR CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "TELECIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-966-5385"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPPER CANYON SENIOR CARE INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aging Well Home Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Katherine Jean Cooke, D.D.S
• Courtney Nicole Cooper, AGACNP
• Jordon Cooper
• Cope Prosthetics Inc
• Tristan Copeland, MD
• Copper Canyon Smiles
• Kimberly Corcoran, FNP
• Megan Cordaro
• Gloria Cordova Rodriguez
• Rebeca Raquel Cordova

• Assisted Living Facility in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.