NPIMap

Organization Active NPI

Epiphany Care Homes Inc

Doing business as Beachcomber Home Icf/DD-N

  • Intellectual Disabilities Intermediate Care Facility
  • Simi Valley, CA
National Provider Identifier
1558498683
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
EPIPHANY CARE HOMES INC
Doing business as
Beachcomber Home Icf/DD-N
Practice address
3224 Wilmot St
Simi Valley, CA 93063-2656
Phone
(805) 485-8111
Fax
(805) 485-8170
NPI assigned
Feb 27, 2007
Last updated
Sep 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Matthew Steinorth
Title
President
Phone
(805) 485-8111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

3224 Wilmot St
Simi Valley, CA 93063-2656

Mailing address

1331 Doris Ave
Oxnard, CA 93030-4409
Phone (805) 485-8111

Other identifiers 1

IdentifierTypeStateIssuer
LTC80371FMedicaidCA

Other names 1

  • BEACHCOMBER HOME ICF/DD-N Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558498683. Details of each certification follow.

  • CCN 05G103 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G103

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Beachcomber Home ICF/DD-N
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 5, 1983
Last certification
Mar 25, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
3224 Wilmot Street
Simi Valley, CA 93063

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1070880Beachcomber Home3224 Wilmot St, Simi Valley, CA 93063Certificate of waiverSep 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Epiphany Care Homes Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1558498683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 DORIS AVE",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930304409",
            "telephone_number": "805-485-8111",
            "fax_number": "805-485-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 WILMOT ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632656",
            "telephone_number": "805-485-8111",
            "fax_number": "805-485-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY CARE HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "STEINORTH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-485-8111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80371F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEACHCOMBER HOME ICF/DD-N",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.