Organization Active NPI

CRG Lynwood, LLC

Doing business as Lynwood Manor Healthcare Center

  • Skilled Nursing Facility
  • Adrian, MI
National Provider Identifier
1023315421
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 CenterCCN 235182 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Oct 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8466.3 residents per day on average
Penalties (3 years)
1Fines totaling $23,761

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Daniel Lev Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2022 86.59%
Corporate OfficerManager Dec 1, 2022
Kimberlee D Weiss Individual W-2 Managing EmployeeAdministrator Oct 23, 2020
Jeffrey H Kagan Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2012 13.4%
CRG Lynwood Holdings LLC Organization, Skokie, IL Created for acquisition, For-profit 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.

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

Sources for this page

Verify at the official NPI Registry.