Provider Demographics
NPI:1588544944
Name:CANYON VIEW CARE HOME, INC
Entity type:Organization
Organization Name:CANYON VIEW CARE HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMANI
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:909-548-1769
Mailing Address - Street 1:6369 VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-3328
Mailing Address - Country:US
Mailing Address - Phone:928-970-2018
Mailing Address - Fax:
Practice Address - Street 1:6369 VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-3328
Practice Address - Country:US
Practice Address - Phone:928-970-2018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home