Active NPI
CRG Lynwood, LLC
Doing business as Lynwood Manor Healthcare Center
- Skilled Nursing Facility
- Adrian, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CRG LYNWOOD, LLC
- Doing business as
- Lynwood Manor Healthcare Center
- Practice address
- 730 Kimole LN
Adrian, MI 49221-1463 - Phone
- (517) 263-6771
- Fax
- (517) 265-8599
- NPI assigned
- Feb 21, 2011
- Last updated
- Dec 17, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Abraham Gutnicki
- Title
- Member
- Phone
- (847) 933-9280
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
730 Kimole LN
Adrian, MI 49221-1463
Mailing address
4711 Golf Rd
Suite 200
Skokie, IL 60076-1224
Phone (847) 933-9280
Other names 1
- Lynwood Manor Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110606000418 | MI | Part A Provider - Skilled Nursing Facility | 2769669423 | Practice locations: Adrian, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1023315421. Details of each certification follow.
Skilled nursing facility certification: CCN 235182
- Legal name
- CRG LYNWOOD, LLC
- Doing business as
- LYNWOOD MANOR HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 1974
- Last certification
- Jun 4, 2025
- Beds
- 84
- Ownership / control type
- Individual
- Most recent change of ownership
- Jun 1, 2011
- Organization structure
- LLC
- Enrollment address
- 730 Kimole Lane
Adrian, MI 49221-1463 - Nursing home name
- LYNWOOD MANOR HEALTHCARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Lynwood Manor Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Oct 1, 1974
- Medicare certification status
- Active
- Certified beds
- 84
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Daniel Lev | 5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 86.59% |
| Corporate Officer | Dec 1, 2022 | ||
| Kimberlee D Weiss | W-2 Managing Employee | Oct 23, 2020 | |
| Jeffrey H Kagan | 5% Or Greater Indirect Ownership Interest | Mar 1, 2012 | 13.4% |
| CRG Lynwood Holdings LLC | 5% Or Greater Direct Ownership Interest | Jun 2, 2011 | 100% |
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Internal Medicine Physician
- Hudson, MI
- NPI 1841295698
-
- Family Medicine Physician
- Maumee, OH
- NPI 1922147818
-
- Family Medicine Physician
- Maumee, OH
- NPI 1538145925
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": "1298246400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1418774400000",
"number": "1023315421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4711 GOLF RD",
"address_2": "SUITE 200",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761224",
"telephone_number": "847-933-9280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 KIMOLE LN",
"city": "ADRIAN",
"state": "MI",
"postal_code": "492211463",
"telephone_number": "517-263-6771",
"fax_number": "517-265-8599"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CRG LYNWOOD, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-21",
"last_updated": "2014-12-17",
"status": "A",
"authorized_official_last_name": "GUTNICKI",
"authorized_official_first_name": "ABRAHAM",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "847-933-9280"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lynwood Manor Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Adrian, MI
- Country Market Pharmacy
- County of Lenawee (Lenawee County Health Department)
- County of Lenawee (Lenawee County Health Department)
- James David Courter, PT
- Samantha Cowen, LMSW
- CRG Lynwood, LLC (Lynwood Manor Healthcare Center)
- Dawn Crisman, NP
- Marvin Crisostomo, OTRL
- Crocetto Chiropractic Center, P.C. (Crocetto Chiropractic Wellness Center)
- Jason Croci
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.