CANYON RIVER STAFFING (NPI# 1669606943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669606943 |
| Entity Type | Organization |
| Organization Name | CANYON RIVER STAFFING |
| Practice Address |
265 Blair Dr Apt A Jackson WY 83002 |
| Mailing Address |
Po Box 14622 Jackson WY 83002-4622 |
| Practice Telephone | 1307413690 |
| Mailing Telephone | 1307413690 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-05-14 |
| Authorized Official Name | MS. MAMIE LOU THURSTON (PRESIDENT AND OWNER) |
| Authorized Official Telephone | 13074136909 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251J00000X | Nursing Care | 18595 | WY | Agencies |
| Y | 253Z00000X | In Home Supportive Care | 18595 | WY | Agencies |
| Street Address |
265 BLAIR DR APT A |
| City | JACKSON |
| State | WY |
| Zip Code | 83002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659836336 | Casey Orzech | Registered Nurse | 4584 Fishing Club Drive, Jackson, WY 83002 | 2019-02-06 |
| 1093050510 | Irene Ann Nelson | Physician Assistant | 1490 Gregory Lane, Jackson, WY 83002 | 2012-12-10 |
| 1548590102 | Amy Pitman | Social Worker | 460 Cache Street, Jackson, WY 83002 | 2010-01-05 |
| 1477745842 | Catherine Haynes Wuthrich | Psychiatry & Neurology | 2092 Lilac Lane, Jackson, WY 83002 | 2007-08-09 |
| 1952518086 | Jennifer Agger Kandolin | Counselor | 420 South Jackson St., Jackson, WY 83002 | 2007-05-17 |
| 1992828503 | Ann M Fenn | Obstetrics & Gynecology | 62 Redmond St, Jackson, WY 83002 | 2007-04-09 |
| 1295863504 | Chad Roberts | Optometrist | 110 Buffalo Way, Ste A, Jackson, WY 83002 | 2007-02-28 |
| 1972645315 | Wyoming Eye Care Inc PC | Optometrist | 110 Buffalo Way St A, Jackson, WY 83002 | 2007-02-13 |
| 1386780237 | Charles F Harris | Physician Assistant | 982 W. Broadway, Jackson, WY 83002 | 2007-01-29 |
| 1639249550 | Laura Vignaroli | Family Medicine | 62 Redmond, Jackson, WY 83002 | 2006-11-08 |
| Find all providers in zip 83002 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407067 | Mjp Management LLC | In Home Supportive Care | 1 Comtronics Pl, Jackson, MI 49203-7500 | 2020-11-05 |
| 1639776750 | Hope Supportive LLC. | In Home Supportive Care | 6295 Old Canton Rd Apt 19d, Jackson, MS 39211-2934 | 2020-10-01 |
| 1548890858 | Davis Healthcare Facility | In Home Supportive Care | 419 S State St Ste B100-4, Jackson, MS 39201-5005 | 2020-01-26 |
| 1104456979 | Carefree Living At Home LLC | In Home Supportive Care | 460 Briarwood Dr Ste 400-1010, Jackson, MS 39206-3051 | 2020-01-21 |
| 1164088415 | Canaan Homehealth Care | In Home Supportive Care | 17 Danielle Ct, Jackson, NJ 08527-2929 | 2019-05-13 |
| 1356801393 | Victor M Pickett | In Home Supportive Care | 227 Kilmaine Ct, Jackson, MS 39209-3651 | 2019-03-25 |
| 1902360571 | Resilience Home Care Services LLC | In Home Supportive Care | 5135 Galaxie Dr Ste E, Jackson, MS 39206-4300 | 2019-01-28 |
| 1689151789 | Sanedra Pegues | In Home Supportive Care | 4754 Dubarry Ln, Jackson, MS 39209-4929 | 2018-07-23 |
| 1548768708 | Shore Homecare Services LLC | In Home Supportive Care | 25 N County Line Rd Ste 18, Jackson, NJ 08527-1270 | 2018-01-23 |
| 1487161519 | The Journey of Knowledge | In Home Supportive Care | 2460 Terry Rd Ste 400, Jackson, MS 39204-5777 | 2018-01-10 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.