Organization Active NPI

86 Valley Hideaway Drive Opco LLC

Doing business as Clay County Health and Rehabilitation

  • Skilled Nursing Facility
  • Hayesville, NC
National Provider Identifier
1023826229
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
86 VALLEY HIDEAWAY DRIVE OPCO LLC
Doing business as
Clay County Health and Rehabilitation
Practice address
86 Valley Hideaway Dr
Hayesville, NC 28904-9674
Phone
(828) 389-9941
NPI assigned
Dec 20, 2024
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Tiffany Hoback
Title
Manager
Phone
(770) 698-9040

Specialties & licenses 1

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

Addresses

Primary practice location

86 Valley Hideaway Dr
Hayesville, NC 28904-9674

Mailing address

86 Valley Hideaway Dr
Hayesville, NC 28904-9674
Phone (828) 389-9941

Other names 1

  • Clay County Health and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Synergy Healthcare Services

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250715003619 NC Part A Provider - Skilled Nursing Facility 6608381975 Practice locations: Hayesville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023826229. Details of each certification follow.

Skilled nursing facility certification: CCN 345433

Legal name
86 VALLEY HIDEAWAY DRIVE OPCO LLC
Doing business as
CLAY COUNTY HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 30, 1993
Last certification
Feb 27, 2025
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Avardis
Organization structure
LLCProprietary
Enrollment address
86 Valley Hideaway Dr
Hayesville, NC 28904-9674
Nursing home name
CLAY COUNTY HEALTH AND REHABILITATION
Affiliated entity
AVARDIS HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Clay County Health and RehabilitationCCN 345433 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 30, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9077.5 residents per day on average
Chain
Avardis Health38 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
34D0873121Clay County Health and Rehabilitation86 Valley Hideaway Drive, Hayesville, NC 28904Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Networks

  • SC HMO

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Organization, Atlanta, GA LLC, For-profit Adp of the SNF Apr 14, 2025
Mark S Chandross Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
Organization, Kennett Square, PA LLC, For-profit Adp of the SNF Apr 23, 2025
Nu C II Irrevocable Trust Organization, New York, NY Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 50%
Organization, Orlando, FL For-profit Adp of the SNF Apr 14, 2025
Ncop Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 100%
Organization, Lynchburg, VA LLC, For-profit Adp of the SNF May 1, 2025
SNF Care Centers LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 100%
Organization, Woonsocket, RI LLC, For-profit Adp of the SNF Apr 15, 2025
Carlos a Vargas Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
SNF MGR LLC Organization, Atlanta, GA LLC, Management services company, For-profit Operational/Managerial Control May 1, 2025
Adp of the SNF Apr 14, 2025
Kathie Garrett Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
Brandi H Semones Individual Operational/Managerial Control May 1, 2025
Managing Control - Governing Body May 1, 2025
Adp of the SNF May 1, 2025
Hayesville Parentco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Direct Ownership Interest Jun 1, 2025 100%
Zenith Holdco II LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 100%
Evh Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 100%
Tiffany Hoback Individual Operational/Managerial Control May 1, 2025
Managing Control - Governing Body May 1, 2025
Adp of the SNF May 1, 2025
Zenith Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 100%
Tequilla Jones Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
Nu C Irrevocable Trust Organization, New York, NY Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 50%

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 41

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

View all 41

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1023826229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 VALLEY HIDEAWAY DR",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "289049674",
            "telephone_number": "828-389-9941",
            "fax_number": "828-389-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 VALLEY HIDEAWAY DR",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "289049674",
            "telephone_number": "828-389-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "86 VALLEY HIDEAWAY DRIVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-20",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "HOBACK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-698-9040"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Synergy Healthcare Services",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clay County Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayesville, NC

Sources for this page

Verify at the official NPI Registry.