NPIMap

Organization Active NPI

S Arkansas Avenue Operating LLC

Doing business as The Blossoms at Dierks Rehab & Nursing Center

  • Skilled Nursing Facility
  • Dierks, AR
National Provider Identifier
1023801628
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
S ARKANSAS AVENUE OPERATING LLC
Doing business as
The Blossoms at Dierks Rehab & Nursing Center
Practice address
402 S Arkansas Ave
Dierks, AR 71833-9001
Phone
(870) 286-3100
NPI assigned
May 27, 2025
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Israel Ganz
Title
Director
Phone
(732) 366-5705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

402 S Arkansas Ave
Dierks, AR 71833-9001

Mailing address

1999 Cedarbridge Ave Ste 3B
Lakewood, NJ 08701-7048
Phone (732) 366-5705

Other names 1

  • The Blossoms at Dierks Rehab & Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251022002764 AR Part A Provider - Skilled Nursing Facility 8527556471 Practice locations: Dierks, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023801628. Details of each certification follow.

Skilled nursing facility certification: CCN 045346

Legal name
S ARKANSAS AVENUE OPERATING LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 18, 1998
Last certification
Jun 12, 2025
Beds
70
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Ascend Healthcare
Most recent change of ownership
Jun 1, 2022
Organization structure
LLCProprietary
Enrollment address
402 S Arkansas Ave
Dierks, AR 71833-9001
Nursing home name
DIERKS HEALTH AND REHAB OF DIERKS
Affiliated entity
THE BLOSSOMS REHAB & NURSING CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Blossoms at Dierks Rehab and Nursing CenterCCN 045346 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 18, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7056.6 residents per day on average
Chain
The Blossoms Rehab & Nursing Center23 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0948382Blossoms at Dierks, the402 South Arkansas Avenue, Dierks, AR 71833Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory

Locations

402 S Arkansas Ave
Dierks, AR 71833
Phone (870) 286-3100

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Organization, Portland, OR LLC, Consulting firm Adp of the SNF Aug 13, 2025
Individual Adp of the SNF Jun 30, 2025
Ozark Opco Holding LLC Organization, Hot Springs, AR LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2025 100%
Direct Ownership Interest Jun 30, 2025 100%
Organization, Fort Smith, AR LLC, Medical provider/supplier Adp of the SNF Aug 13, 2025
Kari Dee Robbins Individual Operational/Managerial Control Jun 30, 2025
Adp of the SNF Jun 30, 2025
Individual Adp of the SNF Jun 30, 2025
Organization, Newark, NJ LLC Adp of the SNF Aug 18, 2025
Individual Adp of the SNF Jun 30, 2025
Organization, Lakewood, NJ Corporation, Consulting firm Adp of the SNF Aug 13, 2025
Yisroel Ganz Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2025 4%
Adp of the SNF Jun 30, 2025
Indirect Ownership Interest Jun 30, 2025 4%
Organization, Plano, TX LLC Adp of the SNF Aug 13, 2025
Organization, Hot Springs, AR LLC, Consulting firm Adp of the SNF Sep 1, 2025
ZCS Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2025 96%
Indirect Ownership Interest Jun 30, 2025 96%
Organization, Lakewood, NJ LLC, Consulting firm Adp of the SNF Aug 13, 2025
Ar Opco Members II LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2025 4%
Indirect Ownership Interest Jun 30, 2025 4%
Shlomo Z Scheinbaum Individual 5% Or Greater Indirect Ownership InterestCeo Jun 30, 2025 96%
Adp of the SNF Jun 30, 2025
Indirect Ownership Interest Jun 30, 2025 96%
Organization, Lakewood, NJ LLC, Consulting firm Adp of the SNF Aug 13, 2025

Facilities with the same owner 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1023801628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 CEDARBRIDGE AVE STE 3B",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017048",
            "telephone_number": "732-366-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S ARKANSAS AVE",
            "city": "DIERKS",
            "state": "AR",
            "postal_code": "718339001",
            "telephone_number": "870-286-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S ARKANSAS AVENUE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "GANZ",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-366-5705"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Blossoms at Dierks Rehab & Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dierks, AR

Sources for this page

Verify at the official NPI Registry.