Provider Demographics
NPI:1720432800
Name:CANYON WEST LOS ANGELES LLC
Entity Type:Organization
Organization Name:CANYON WEST LOS ANGELES LLC
Other - Org Name:FOUNDATIONS LOS ANGELES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP-CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-382-3319
Mailing Address - Street 1:1000 HEALTH PARK DRIVE
Mailing Address - Street 2:BUILDING THREE, SUITE 400
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-386-7255
Mailing Address - Fax:615-645-7445
Practice Address - Street 1:17167 W. VENTURA BOULEVARD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:818-464-1700
Practice Address - Fax:615-373-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder