Healthcare Provider Details

I. General information

NPI: 1669610267
Provider Name (Legal Business Name): EPIPHANY CARE HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 CENTRAL AVE
FILLMORE CA
93015-1332
US

IV. Provider business mailing address

1331 DORIS AVE
OXNARD CA
93030-4409
US

V. Phone/Fax

Practice location:
  • Phone: 805-524-4003
  • Fax: 805-485-8170
Mailing address:
  • Phone: 805-485-8111
  • Fax: 805-485-8170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number050000527
License Number StateCA

VIII. Authorized Official

Name: MR. MATTHEW STEINORTH
Title or Position: PRESIDENT
Credential:
Phone: 805-485-8111