MAPLE MOON RECOVERY
NPI 1184384786
Substance Abuse Rehabilitation Facility in Winnetka, CA
About Maple Moon Recovery NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAPLE MOON RECOVERY (NPI 1184384786) is a healthcare organization registered as a substance abuse rehabilitation facility in Winnetka, California and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through January 10, 2028 and lists Ashley Ingram, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 05D2248079
Maple Moon LLC · Winnetka, CAFrequently 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 Maple Moon Recovery's NPI number?
The NPI number for Maple Moon Recovery is 1184384786. It was assigned to this organization in the NPPES registry on December 22, 2021.
Where is Maple Moon Recovery located?
Maple Moon Recovery is located at 20400 Hemmingway St, Winnetka, CA 91306. The listed phone number is (213) 713-8027.
What is Maple Moon Recovery's specialty?
The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
Does Maple Moon Recovery hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2248079) is associated with this NPI, valid through January 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Maple Moon Recovery was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Maple Moon Recovery · NPI 1184384786
Substance Abuse Rehabilitation Facility organization in Winnetka, California. Organization record, active in the CMS NPPES registry since December 22, 2021.
## Identity
- **NPI:** 1184384786 (Entity type: Organization)
- **Enumerated:** December 22, 2021
- **Primary specialty:** Substance Abuse Rehabilitation Facility · taxonomy 324500000X
- **Organization subpart:** No
- **Authorized official:** Ashley Ingram, OWNER
## Practice location
- **Address:** 20400 HEMMINGWAY ST, Winnetka, CA 91306-2249
- **Phone:** (213) 713-8027
## Record status
- **NPPES last updated:** December 22, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1184384786) · Data from the CMS NPPES public registry.