NPIMap

Organization Active NPI

Canyon Nevada LLC

Doing business as Canyon Home Care & Hospice

  • Community Based Hospice Care Agency
  • Laughlin, NV
National Provider Identifier
1922520675
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CANYON NEVADA LLC
Doing business as
Canyon Home Care & Hospice
Practice address
3100 S Needles Hwy Ste 500
Laughlin, NV 89029-0815
Phone
(702) 868-1400
Fax
(702) 720-1423
NPI assigned
Jul 14, 2017
Last updated
May 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 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
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

3100 S Needles Hwy Ste 500
Laughlin, NV 89029-0815

Mailing address

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

Other practice location 1

786 W Pioneer Blvd Ste 105
Mesquite, NV 89027-8888
Phone (702) 897-9566

Other names 1

  • Canyon Home Care & Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170830000892 NV Part A Provider - Hospice 0648543462 Practice locations: Laughlin, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922520675. Details of each certification follow.

Hospice certification: CCN 291557

Legal name
CANYON NEVADA LLC
Doing business as
CANYON HOME CARE & HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 8, 2018
Last certification
Jan 15, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
May 31, 2017 in NV
Enrollment address
3100 S Needles Hwy
Ste 600
Laughlin, NV 89029-0815

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Canyon Home Care & HospiceCCN 291557 · All quality measures
Ownership
For-Profit
Certified
Mar 8, 2018
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Canyon Home Care2 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.

Member of 1

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

Locations

400 Shadow Ln
Ste 202
Las Vegas, NV 89106
Phone (702) 331-5230

400 Shadow Ln
Ste 210
Las Vegas, NV 89106
Phone (480) 843-9877

3100 S Needles Hwy
Ste 500
Laughlin, NV 89029
Phone (702) 703-1262

3100 S Needles Hwy
Ste 600
Laughlin, NV 89029
Phone (702) 868-1400

786 W Pioneer Blvd
Ste 105
Mesquite, NV 89027
Phone (702) 897-9566

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
Orange Healthcare, LLC Organization, Holladay, UT LLC 5% Or Greater Indirect Ownership Interest May 31, 2017 50%
Kenneth Edwin Norris Individual 5% Or Greater Indirect Ownership Interest May 31, 2017 50%
Corporate OfficerManaging Member May 31, 2017 100%
Operational/Managerial ControlManaging Partner May 31, 2017 100%
Tyson Cichos Individual 5% Or Greater Indirect Ownership Interest May 31, 2017 25%
Cory R Robison Individual 5% Or Greater Indirect Ownership Interest May 31, 2017 25%
Home Caregivers Partnership, LLC Organization, Salt Lake City, UT LLC 5% Or Greater Direct Ownership Interest May 31, 2017 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1922520675",
    "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": "3100 S NEEDLES HWY STE 500",
            "city": "LAUGHLIN",
            "state": "NV",
            "postal_code": "890290815",
            "telephone_number": "702-868-1400",
            "fax_number": "702-720-1423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "786 W Pioneer Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890278888",
            "country_code": "US",
            "telephone_number": "702-897-9566",
            "fax_number": "801-531-1949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANYON NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laughlin, NV

Sources for this page

Verify at the official NPI Registry.