MOONSTONE HOME ICF/DD-N
NPI 1083741151
Intermediate Care Facility, Intellectual Disabilities in Simi Valley, CA

Active since February 27, 2007CLIA 05D1070883 · Waiver
2331 KNOLLHAVEN ST, SIMI VALLEY, CA 93065(805) 485-8111(805) 485-8170 Get Directions Write a Review

NPPES record last updated: September 19, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Moonstone Home Icf/dd-n NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOONSTONE HOME ICF/DD-N (NPI 1083741151) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Simi Valley, California and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through September 7, 2026 and lists Matthew Steinorth, President, as its authorized official.

NPPES Registry Identity

NPI1083741151
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameEPIPHANY CARE HOMES INC
Location Address2331 KNOLLHAVEN STSimi Valley, CA 93065-2528
Mailing Address1331 Doris AveOxnard, CA 93030-4409 · (805) 485-8111 · Fax (805) 485-8170
Fax(805) 485-8170
Organization SubpartNo
Authorized OfficialMatthew SteinorthPresident · (805) 485-8111
Enumeration DateFebruary 27, 2007
Last NPPES UpdateSeptember 19, 2011
NPI 1083741151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

2331 KNOLLHAVEN ST, Simi Valley, CA 93065

Other Names 1

Doing Business AsMoonstone Home Icf/dd-n

Other Identifiers 1

MedicaidLTC80026GCA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1070883

Moonstone Home · Simi Valley, CA
Active · expires Sep 7, 2026
CLIA Number05D1070883
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateSeptember 8, 2024
Certificate Expiration DateSeptember 7, 2026
Laboratory DirectorZia Abdo M. Memar
Laboratory Phone(805) 527-1879
Laboratory LocationMoonstone Home2331 Knollhaven Street, Simi Valley, CA 93065
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083741151, enumerated as an "organization" on February 27, 2007.

The provider is located at 2331 KNOLLHAVEN ST SIMI VALLEY, CA 93065 and the phone number is (805) 485-8111.

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.