Maybrook-P Millville Opco, LLC
Organization Active NPI Skilled Nursing Facility · Millville, PA
NPI 1043672520 · NPPES record last updated Mar 24, 2016
Key facts
- NPI
- 1043672520
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- MAYBROOK-P MILLVILLE OPCO, LLC
- Practice address
- 48 Haven Lane
Millville, PA 17846-0320 - Phone
- (570) 458-5566
- NPI assigned
- Mar 24, 2016
- Organization subpart
- No
Authorized official
- Name
- Ephram M Lahasky
- Title
- Member
- Phone
- (646) 772-3668
Owners & managing parties with NPI records 1
-
Robert J. Pearlstein, D.O.
Facilities with the same owner 64
Practitioners 3
-
Jason John Clarity, D.O.
-
Osman Elnour Bahar Osman, M.D.
-
Robert J. Pearlstein, D.O.
Affiliated clinicians 2
-
Jason John Clarity, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Gardens at Millville, the
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 1, 1992
- Medicare certification status
- Active
- Certified beds
- 110 · 101.6 residents per day on average
- Chain
- Priority Healthcare Group
- Penalties (3 years)
- 2 · fines totaling $25,275
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0904010 | Gardens at Millville, the | Certificate of waiver | Oct 3, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Skilled nursing facility certification: CCN 395872
- Legal name
- MAYBROOK-P MILLVILLE OPCO LLC
- Doing business as
- THE GARDENS AT MILLVILLE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1992
- Last certification
- Feb 14, 2025
- Beds
- 110
- Ownership / control type
- Corporation
- Multi-facility organization
- Priority Healthcare Group
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 4, 2015 in DE
- Enrollment address
- 48 Haven Lane
Millville, PA 17846-0320 - Nursing home name
- GARDENS AT MILLVILLE, THE
- Affiliated entity
- PRIORITY HEALTHCARE GROUP
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Gabriel J Sebbag |
5% Or Greater Indirect Ownership Interest | Aug 15, 2016 | 5% |
| Samara Holdings Company LLC |
5% Or Greater Indirect Ownership Interest | Jan 28, 2020 | 10.25% |
| Maybrook-P Millville Propco LLC |
Adp of the SNF | Aug 15, 2016 | |
| Lme Family Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jan 28, 2020 | 10.25% |
| Priority Care Group LLC |
Operational/Managerial Control | Jan 1, 2019 | |
| Vincent Urban |
Operational/Managerial Control | Aug 15, 2016 | |
| Adp of the SNF | Apr 6, 2025 | ||
| Fair Oaks Family Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jan 28, 2020 | 11.87% |
| Strawberry Hill Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jan 28, 2020 | 10.25% |
| Robert J Pearlstein |
Operational/Managerial Control | Jul 1, 2021 | |
| Adp of the SNF | Jul 1, 2025 | ||
| BL Capital Group Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jan 28, 2020 | 23.75% |
| Summation Financial Services LLC |
Operational/Managerial Control | Jan 1, 2019 | |
| Adp of the SNF | Jul 1, 2025 | ||
| Philipson Family Limited Liability Company, LLC |
5% Or Greater Indirect Ownership Interest | Aug 15, 2016 | 25.63% |
| Clinical Consulting Services LLC |
Operational/Managerial Control | Jan 1, 2019 | |
| Adp of the SNF | Jul 1, 2025 | ||
| Maybrook-P Opco Holdings LLC |
5% Or Greater Direct Ownership Interest | Aug 15, 2016 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160921000222 | PA | Part a Provider - Skilled Nursing Facility | 4789971698 | Practice locations: Millville, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
48 Haven Lane
Millville, PA 17846-0320
Mailing address
34 Lord Ave
Lawrence, NY 11559-1324
Other names
- The Gardens at Millville
Other providers in Millville, PA
- Jaclyn Tara Delauretis
- Michael L. Dubartell
- Linsey Fisk
- Dawn R Hornberger
- Jennifer Triassi LLC
- Millville Area School District
- Millville Community Fire Company
- Millville Leasing Partnership
- Brigid Flynn Pugh
- Reliant Millville Holdings LLC
All providers in Millville, PA · Skilled Nursing Facility in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2016. 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.