- Enrollment id
- O20150407001873
- Enrollment state
- NV
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1447660618
- Multiple npi flag
- N
- Ccn
- 295093
- Associate id
- 6800114620
- Organization name
- YATE HOLDINGS LLC
- Doing business as name
- CANYON VISTA POST-ACUTE
- Incorporation date
- 2013-06-18
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CANYON VISTA POST ACUTE
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 6352 MEDICAL CENTER ST
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891482413