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CANYON HOME III

Intermediate Care Facility, Mental Illness

Shadow Hills, California

Provider NPI: 1669527941

Organization Information:
Organization Name:  CANYON HOME III


Practice Location:
10712 ARTRUDE ST  SHADOW HILLS, CA 91040 US
Tel: 818-353-1514  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness
CA

Other Provider Identifiers:

IssuerNumberStateType
LTC60886FCA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




INTERMEDIATE CARE JOBS CA - Page 1



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