Healthcare Provider Details

I. General information

NPI: 1215848668
Provider Name (Legal Business Name): CANYON STATE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 S 5TH AVE STE J
SAFFORD AZ
85546-2715
US

IV. Provider business mailing address

3535 W ROBBIE LN
THATCHER AZ
85552-5031
US

V. Phone/Fax

Practice location:
  • Phone: 928-322-3663
  • Fax:
Mailing address:
  • Phone: 928-322-3663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BRANDON BRYCE
Title or Position: OWNER
Credential: RN
Phone: 928-322-3663