Healthcare Provider Details

I. General information

NPI: 1053242313
Provider Name (Legal Business Name): CANYON COUNTRY ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18792 FLYING TIGER DR
CANYON COUNTRY CA
91387-8250
US

IV. Provider business mailing address

18792 FLYING TIGER DR
CANYON COUNTRY CA
91387-8250
US

V. Phone/Fax

Practice location:
  • Phone: 661-235-3336
  • Fax: 662-235-3337
Mailing address:
  • Phone: 661-235-3336
  • Fax: 662-235-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ARTAVAZD ARTHUR TER-ARSENYAN
Title or Position: OWNER
Credential: CO, CFO
Phone: 818-800-9949