NPIMap

Organization Active NPI

K & K Health Care, LLC

  • Skilled Nursing Facility
  • Pottsville, PA
National Provider Identifier
1043697212
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
061502 Issued in PA
Legal business name
K & K HEALTH CARE, LLC
Practice address
1 Matthew LN
Pottsville, PA 17901-2288
Phone
(570) 644-0489
NPI assigned
Apr 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Mr. Michael Kelly
Title
Managing Member
Phone
(570) 969-2188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 061502 PA Primary

Addresses

Primary practice location

1 Matthew LN
Pottsville, PA 17901-2288

Mailing address

401 Moltke Ave
Scranton, PA 18505-2886

Other names 1

  • Green Valley Skilled Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150826000568 PA Part A Provider - Skilled Nursing Facility 3678889383 Practice locations: Pottsville, PA

Skilled nursing facility certification: CCN 396086

Legal name
K & K HEALTH CARE LLC
Doing business as
GREEN VALLEY SKILLED NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 11, 2003
Last certification
Feb 28, 2025
Beds
48
Ownership / control type
Limited Liability Corporation
Organization structure
PartnershipProprietary
Incorporated
Jan 12, 2015 in PA
Enrollment address
1 Matthew LN
Pottsville, PA 17901-2288
Nursing home name
GREEN VALLEY SKILLED NURSING AND REHABILITATION CE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Green Valley Skilled Nursing and Rehabilitation CeCCN 396086
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 - Limited Liability company
Certified
Mar 11, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4843.7 residents per day on average
Penalties (3 years)
1Fines totaling $10,033

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
39D0985694Green Valley Skilled Nursing1 Matthew Lane, Pottsville, PA 17901Certificate of waiverApr 25, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 31

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

NameRoleSinceShare
PA Tenant 3 Mezz Holdings, LLC Organization, Scranton, PA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 100%
Stephen M Kuzio Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Michael P Kelly Individual 5% Or Greater Direct Ownership InterestManager Mar 28, 2023 35%
Operational/Managerial Control May 1, 2015
Managing Control - Governing BodyManager May 1, 2015
Adp of the SNF May 1, 2015
PA Tenant 3 Mezz, LLC Organization, Beachwood, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 28, 2023 100%
Organization, Dunmore, PA Corporation, Financial institution, For-profit Adp of the SNF Apr 14, 2025
Organization, Scranton, PA LLC, For-profit Adp of the SNF Mar 28, 2023
Organization, Woodmere, OH For-profit Adp of the SNF Apr 14, 2025
Organization, Beachwood, OH Adp of the SNF Mar 28, 2023
Susan Keefer Individual 5% Or Greater Direct Ownership Interest Mar 28, 2023 35%
Operational/Managerial Control May 1, 2015
Adp of the SNF May 1, 2015
Organization, Scranton, PA LLC, For-profit Adp of the SNF Mar 28, 2023
Diana D Lazur Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Organization, Scranton, PA LLC, For-profit Adp of the SNF Mar 28, 2023
Individual Adp of the SNF Mar 1, 2025
Eaz Operating Company, LLC Organization, Scranton, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 35%
Maryann Moore Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Organization, Scranton, PA LLC, For-profit Adp of the SNF Mar 28, 2023
Oxford Finance LLC Organization, Alexandria, VA LLC, Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Mar 28, 2023 100%
5% Or Greater Security Interest Mar 28, 2023 100%
Adp of the SNF Mar 10, 2025
George S. Repchick 2020 Family Dynasty Trust Organization, Shaker Heights, OH For-profit 5% Or Greater Indirect Ownership Interest Mar 28, 2023 30%
Senior Health Care Solutions Organization, Scranton, PA LLC, Management services company Operational/Managerial Control Jan 1, 2022 100%
Adp of the SNF Mar 13, 2025
Timothy M Purcell Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Individual Adp of the SNF Mar 1, 2025
Organization, Manalapan, NJ LLC, Consulting firm, For-profit Adp of the SNF Mar 13, 2025
Bonita K Martin Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Help for the Kids, LLC Organization, Scranton, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 35%
PA Tenant 3 Holdings, LLC Organization, Beachwood, OH LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 28, 2023 100%
Susan M Eye Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Individual Adp of the SNF Mar 1, 2025
Danielle L Belles Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Individual Adp of the SNF Mar 1, 2025
2020 GSR Dynasty LLC Organization, Beachwood, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 30%
Organization, Scranton, PA LLC, Holding company, For-profit Adp of the SNF Mar 28, 2023

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 23

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

View all 23

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1430092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1043697212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MOLTKE AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MATTHEW LN",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012288",
            "telephone_number": "570-644-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & K HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-27",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "570-969-2188",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "061502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Valley Skilled Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.