CLR Granville LLC
Organization Active NPI Skilled Nursing Facility · Granville, NY
NPI 1033645858 · NPPES record last updated Jul 24, 2017
Key facts
- NPI
- 1033645858
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 5725303N (NY)
- Legal business name
- CLR GRANVILLE LLC
- Practice address
- 10421 State Route 40
Granville, NY 12832-5713 - Phone
- (518) 642-2346
- Fax
- (518) 642-3870
- NPI assigned
- May 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Amir Abramchik
- Title
- Member
- Phone
- (718) 931-9700
Practitioners 2
-
Mikram Jafri, MD
Affiliated clinicians 2
-
Mikram Jafri, MD
Medicare Care Compare: Nursing home
- Listed as
- Slate Valley Center for Rehabilitation and Nursing
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 12, 1990
- Medicare certification status
- Active
- Certified beds
- 88 · 86.2 residents per day on average
- Chain
- Centers Health Care
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0667962 | Slate Valley Center for Rehabilitation | Certificate of waiver | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Skilled nursing facility certification: CCN 335711
- Legal name
- CLR GRANVILLE LLC
- Doing business as
- SLATE VALLEY CENTER FOR REHABILITATION AND NURSING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 12, 1990
- Last certification
- Apr 18, 2025
- Beds
- 88
- Ownership / control type
- Corporation
- Multi-facility organization
- Centers Healthcare
- Most recent change of ownership
- Sep 1, 2017
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 30, 2017 in NY
- Enrollment address
- 10421 State Route 40
Granville, NY 12832-5713 - Nursing home name
- SLATE VALLEY CENTER FOR REHABILITATION AND NURSING
- Affiliated entity
- CENTERS HEALTH CARE
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Amir Abramchik |
5% Or Greater Direct Ownership Interest |
Sep 1, 2017 | 50% |
| Hillel Weinberger |
5% Or Greater Direct Ownership Interest |
Sep 1, 2017 | 50% |
| Kenneth Rozenberg |
5% Or Greater Direct Ownership Interest | Sep 28, 2017 | 9% |
| Jeremy Boshes |
W-2 Managing Employee |
Sep 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171012000542 | NY | Part a Provider - Skilled Nursing Facility | 6103191440 | Practice locations: Granville, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 5725303N | NY | Yes |
Addresses
Primary practice location
10421 State Route 40
Granville, NY 12832-5713
Mailing address
4770 White Plains Rd
Bronx, NY 10470-1104
Phone (718) 931-9700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01167931 | Medicaid | NY |
Other names
- Slate Valley Center for Rehabilitation and Nursing
Other providers in Granville, NY
- 73 North of Granville, Inc.
- Courtney Beecher
- Steven Benson
- Bianca B. Bernard
- Jennifer Blais
- Harvey Samuel Coco
- Timothy G Cook
- April Lynn Cosey
- Michelle Karen Daigle
- W Marvin Day
All providers in Granville, NY · Skilled Nursing Facility in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.