NPIMap

Organization Active NPI

Havencrest Rehabilitation and Healthcare Center LLC

  • Skilled Nursing Facility
  • Monongahela, PA
National Provider Identifier
1003623133
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAVENCREST REHABILITATION AND HEALTHCARE CENTER LLC
Practice address
1277 Country Club Rd
Monongahela, PA 15063-1057
Phone
(724) 258-3000
NPI assigned
Dec 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Joshua Eisen
Title
Authorized Representative
Phone
(724) 258-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1277 Country Club Rd
Monongahela, PA 15063-1057

Mailing address

229 Route 70 FL 2
Toms River, NJ 08755-1026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250624001883 PA Part A Provider - Skilled Nursing Facility 4981116191 Practice locations: Monongahela, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003623133. Details of each certification follow.

Skilled nursing facility certification: CCN 395633

Legal name
HAVENCREST REHABILITATION AND HEALTHCARE CENTER LLC
Doing business as
HAVENCREST REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1984
Last certification
Feb 20, 2025
Beds
48
Ownership / control type
Limited Liability Corporation
Organization structure
LLC
Enrollment address
1277 Country Club Rd
Monongahela, PA 15063-1057
Nursing home name
HAVENCREST REHABILITATION AND HEALTHCARE CENTER
Affiliated entity
CORE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Havencrest Rehabilitation and Healthcare CenterCCN 395633 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 1, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4843.8 residents per day on average
Chain
Core Healthcare7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 28

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Organization, Toms River, NJ Indirect Ownership Interest Apr 24, 2025 4.99%
Julie Pattison Individual Operational/Managerial Control Apr 24, 2025
Adp of the SNF Apr 24, 2025
Shai Berdugo Individual 5% Or Greater Indirect Ownership Interest Apr 24, 2025 29.35%
Martin Violago Individual Operational/Managerial Control Apr 24, 2025
Adp of the SNF Apr 24, 2025
Individual Indirect Ownership Interest Apr 24, 2025 0.73%
Organization, Toms River, NJ Indirect Ownership Interest Apr 24, 2025 4.99%
Raintree Consulting Group LLC Organization, Toms River, NJ LLC, Holding company Operational/Managerial Control Apr 24, 2025
Individual Indirect Ownership Interest Apr 24, 2025 1.45%
Organization, Toms River, NJ Indirect Ownership Interest Apr 24, 2025 2.91%
Individual Indirect Ownership Interest Apr 24, 2025 1.45%
Individual Indirect Ownership Interest Apr 24, 2025 0.73%
Organization, Toms River, NJ Indirect Ownership Interest Apr 24, 2025 4.99%
Organization, Toms River, NJ LLC Adp of the SNF Apr 24, 2025
Organization, Toms River, NJ LLC, Holding company Adp of the SNF Apr 24, 2025
G2 Pennsylvania Holdco LLC Organization, Toms River, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 24, 2024 100%
Organization, Toms River, NJ LLC Adp of the SNF Apr 24, 2025
Individual Indirect Ownership Interest Apr 24, 2025 1.45%
Individual Indirect Ownership Interest Apr 24, 2025 4.99%
Individual Indirect Ownership Interest Apr 24, 2025 0.73%
Capital Finance LLC Organization, Baltimore, MD LLC, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Apr 24, 2025
Operational/Managerial Control Apr 24, 2025
Individual Indirect Ownership Interest Apr 24, 2025 4.99%
Organization, Toms River, NJ Indirect Ownership Interest Apr 24, 2025 0.73%
Individual Indirect Ownership Interest Apr 24, 2025 1.45%
Organization, Toms River, NJ LLC Adp of the SNF Apr 24, 2025
Organization, Toms River, NJ Indirect Ownership Interest Apr 24, 2025 4.99%
Joshua Eisen Individual 5% Or Greater Indirect Ownership Interest Apr 24, 2025 29.08%
Operational/Managerial Control Apr 24, 2025
Managing Control - Governing BodyManager of the Manager and Medic Apr 24, 2025
Adp of the SNF Apr 24, 2025
G2 TBD Holdco LLC Organization, Toms River, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 24, 2025 100%
Organization, Toms River, NJ LLC Adp of the SNF Jun 24, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 26

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 26

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1003623133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 ROUTE 70 FL 2",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631057",
            "telephone_number": "724-258-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENCREST REHABILITATION AND HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "EISEN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "724-258-3000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monongahela, PA

Sources for this page

Verify at the official NPI Registry.