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SIMI VALLEY CONGREGATE LIVING, INC
NPI 1134597909
Nursing Facility/Intermediate Care Facility in Simi Valley, CA

Active since September 09, 2015CLIA 05D2294565 · Waiver
2053 SHELBY LN, SIMI VALLEY, CA 93065(805) 900-0588(805) 900-0577 Get Directions Write a Review

NPPES record last updated: November 19, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Simi Valley Congregate Living, Inc NPPES

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

SIMI VALLEY CONGREGATE LIVING, INC (NPI 1134597909) is a healthcare organization registered as a nursing facility/intermediate care facility in Simi Valley, California and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through November 27, 2027 and lists Gary Adams, Ceo, as its authorized official.

NPPES Registry Identity

NPI1134597909
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameSIMI VALLEY CONGREGATE LIVING, INC
Location Address2053 SHELBY LNSimi Valley, CA 93065-2427
Mailing Address2053 Shelby LnSimi Valley, CA 93065-2427 · (805) 900-0588 · Fax (085) 900-0577
Phone(805) 900-0588
Fax(805) 900-0577
Organization SubpartNo
Authorized OfficialGary AdamsCeo · (805) 900-0588
Enumeration DateSeptember 9, 2015
Last NPPES UpdateNovember 19, 2015
✔ NPI 1134597909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
2053 SHELBY LN, Simi Valley, CA 93065
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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 05D2294565

Simi Valley Congregate Living Inc · Simi Valley, CA
Active · expires Nov 27, 2027
CLIA Number05D2294565
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateNovember 28, 2025
Certificate Expiration DateNovember 27, 2027
Laboratory DirectorHanan Lobel
Laboratory Phone(818) 634-6328
Laboratory LocationSimi Valley Congregate Living Inc2053 Shelby Lane, 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 NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simi Valley Congregate Living, Inc's NPI number?

The NPI number for Simi Valley Congregate Living, Inc is 1134597909. It was assigned to this organization in the NPPES registry on September 9, 2015.

Where is Simi Valley Congregate Living, Inc located?

Simi Valley Congregate Living, Inc is located at 2053 Shelby Ln, Simi Valley, CA 93065. The listed phone number is (805) 900-0588.

What is Simi Valley Congregate Living, Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Simi Valley Congregate Living, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2294565) is associated with this NPI, valid through November 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Simi Valley Congregate Living, Inc was last updated on November 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.