Provider Demographics
NPI:1598785081
Name:CANYON HEALTH CARE SERVICES,INC.
Entity Type:Organization
Organization Name:CANYON HEALTH CARE SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:UWAJEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-245-3056
Mailing Address - Street 1:932 N CAMINO SECO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1708
Mailing Address - Country:US
Mailing Address - Phone:520-721-1925
Mailing Address - Fax:520-721-1925
Practice Address - Street 1:932 N CAMINO SECO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1708
Practice Address - Country:US
Practice Address - Phone:520-721-1925
Practice Address - Fax:520-721-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty