Provider Demographics
NPI:1760354740
Name:CANYON OPERATING CO LLC
Entity type:Organization
Organization Name:CANYON OPERATING CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YITZCHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-530-1808
Mailing Address - Street 1:10123 ALLIANCE RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4887
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3625 PARKMOOR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5205
Practice Address - Country:US
Practice Address - Phone:513-530-1808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital