MEDICARE: CANYON ARIZONA HOME CARE & HOSPICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1538016712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANYON ARIZONA HOME CARE & HOSPICE LLC

Provider Business Mailing Address
First Line	:	746 E WINCHESTER ST STE 200
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-8513
Country	:	US
Telephone Number	:	801-485-6166
Fax Number	:	801-531-1949

Provider Business Practice Location Address
First Line	:	10150 W DESERT RIVER BLVD STE A-110
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85307-3008
Country	:	US
Telephone Number	:	602-216-2273
Fax Number	:	602-443-5398

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	BREEZIE LISKEY
Credential	:
Telephone Number	:	801-445-6787

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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