Provider Demographics
NPI:1750187282
Name:CANYON TRAILS ASSISTED LIVING AND MEMORY CARE
Entity type:Organization
Organization Name:CANYON TRAILS ASSISTED LIVING AND MEMORY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:1
Authorized Official - Last Name:SAA
Authorized Official - Suffix:
Authorized Official - Credentials:RCFE
Authorized Official - Phone:818-716-9900
Mailing Address - Street 1:7945 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4733
Mailing Address - Country:US
Mailing Address - Phone:818-716-9900
Mailing Address - Fax:
Practice Address - Street 1:7945 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4733
Practice Address - Country:US
Practice Address - Phone:818-716-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility