Provider Demographics
NPI:1578701173
Name:EPIPHANY CARE HOMES INC
Entity Type:Organization
Organization Name:EPIPHANY CARE HOMES INC
Other - Org Name:RURAL HAVEN HOME ICF/DD-H
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-485-8111
Mailing Address - Street 1:1331 DORIS AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-4409
Mailing Address - Country:US
Mailing Address - Phone:805-485-8111
Mailing Address - Fax:805-485-8170
Practice Address - Street 1:431 SARATOGA ST
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1531
Practice Address - Country:US
Practice Address - Phone:805-524-4003
Practice Address - Fax:805-485-8170
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPIPHANY CARE HOMES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000507315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities