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HEALTHY LIFE CONGREGATE CARE
NPI 1902268758
Nursing Facility/Intermediate Care Facility in Simi Valley, CA

Active since March 22, 2016
3011 PEORIA AVE, SIMI VALLEY, CA 93063(805) 955-0057(805) 728-7454 Get Directions Write a Review

NPPES record last updated: March 22, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Healthy Life Congregate Care NPPES

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

HEALTHY LIFE CONGREGATE CARE (NPI 1902268758) is a healthcare organization registered as a nursing facility/intermediate care facility in Simi Valley, California and active in the NPI registry since March 2016. The organization lists Edmond V Derderyan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1902268758
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameHEALTHY LIFE CONGREGATE CARE
Location Address3011 PEORIA AVESimi Valley, CA 93063-1654
Mailing Address3011 North Peoria AvenueSimi Valley, CA 93063 · (805) 955-0057 · Fax (805) 728-7454
Phone(805) 955-0057
Fax(805) 728-7454
Organization SubpartNo
Authorized OfficialEdmond V DerderyanCeo · (805) 955-0057
Enumeration DateMarch 22, 2016
✔ NPI 1902268758 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.
3011 PEORIA AVE, Simi Valley, CA 93063
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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 Healthy Life Congregate Care's NPI number?

The NPI number for Healthy Life Congregate Care is 1902268758. It was assigned to this organization in the NPPES registry on March 22, 2016.

Where is Healthy Life Congregate Care located?

Healthy Life Congregate Care is located at 3011 Peoria Ave, Simi Valley, CA 93063. The listed phone number is (805) 955-0057.

What is Healthy Life Congregate Care's specialty?

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

When was this NPI record last updated?

The NPPES record for Healthy Life Congregate Care was last updated on March 22, 2016. 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.