Provider Demographics
NPI:1902172547
Name:CANYON CREEK PROPERTY MANAGEMENT LLC
Entity Type:Organization
Organization Name:CANYON CREEK PROPERTY MANAGEMENT LLC
Other - Org Name:CANYON CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, PRESIDENT, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-684-1123
Mailing Address - Street 1:1800 SW FIRST AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5333
Mailing Address - Country:US
Mailing Address - Phone:503-684-1123
Mailing Address - Fax:503-684-2533
Practice Address - Street 1:7235 UNION PARK AVE
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84047-4700
Practice Address - Country:US
Practice Address - Phone:801-568-9909
Practice Address - Fax:801-563-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility