NPIMap

Organization Active NPI

Delaware Valley Skilled Nursing Operating Company, LLC

Doing business as Delaware Valley Skilled Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Matamoras, PA
National Provider Identifier
1043809577
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DELAWARE VALLEY SKILLED NURSING OPERATING COMPANY, LLC
Doing business as
Delaware Valley Skilled Nursing & Rehabilitation Center
Practice address
111 Rivers Edge Dr
Matamoras, PA 18336-2057
Phone
(570) 491-1010
NPI assigned
Jan 11, 2021
Last updated
Jan 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Authorized official

Name
Susan Keefer
Title
Member
Phone
(570) 969-2188

Specialties & licenses 1

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

Addresses

Primary practice location

111 Rivers Edge Dr
Matamoras, PA 18336-2057

Mailing address

401 Moltke Ave
Scranton, PA 18505-2886

Other names 1

  • Delaware Valley Skilled Nursing & 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
O20210216000391 PA Part A Provider - Skilled Nursing Facility 1254746753 Practice locations: Matamoras, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043809577. Details of each certification follow.

Skilled nursing facility certification: CCN 396148

Legal name
DELAWARE VALLEY SKILLED NURSING OPERATING COMPANY, LLC
Doing business as
DELAWARE VALLEY SKILLED NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 4, 2021
Last certification
May 1, 2025
Beds
70
Ownership / control type
Corporation
Multi-facility organization
Senior Healthcare Solutions
Organization structure
LLCProprietary
Incorporated
Dec 17, 2018 in DE
Enrollment address
111 Rivers Edge Dr
Matamoras, PA 18336-2057
Nursing home name
DELAWARE VALLEY SKILLED NURSING & REHABILITATION C

Care Compare: Nursing home

Medicare Care Compare
Listed as
Delaware Valley Skilled Nursing & Rehabilitation CCCN 396148 · All quality measures
Overall star rating
1 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 4, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7061.5 residents per day on average

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
39D2213651Delaware Valley Skilled Nursing and Rehabilitation111 Rivers Edge Drive, Matamoras, PA 18336Certificate of waiverFeb 15, 2027

National Provider Directory

National Provider Directory

Locations

111 Rivers Edge Dr
Matamoras, PA 18336
Phone (570) 491-1010

Ownership & related parties

All disclosed owners & managing parties 40

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%
Rachel N Verde Individual Operational/Managerial Control Nov 1, 2020
Adp of the SNF Nov 1, 2020
Kelly L Fedorka Individual Operational/Managerial Control Jun 1, 2021
Adp of the SNF Jun 1, 2021
Individual Adp of the SNF Mar 1, 2025
Michael P Kelly Individual 5% Or Greater Indirect Ownership InterestAuthorized Manager Mar 28, 2023 35%
Operational/Managerial Control Dec 21, 2020
Managing Control - Governing BodyManager Dec 21, 2020
Adp of the SNF Dec 21, 2020
Organization, Beachwood, OH LLC, Holding company Adp of the SNF Mar 28, 2023
PA Tenant 3 Mezz, LLC Organization, Beachwood, OH LLC, For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 100%
Stepanie a Hanrahan Individual Operational/Managerial Control Jun 1, 2021
Adp of the SNF Jun 1, 2021
Sandra N Pascal Individual Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024
Senior Health Care Solutions LLC Organization, Scranton, PA LLC, Management services company Operational/Managerial Control Jan 1, 2022 100%
Adp of the SNF Mar 5, 2025
Organization, Scranton, PA LLC, Holding company, For-profit Adp of the SNF May 9, 2025
Susan Keefer Individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 35%
Operational/Managerial Control Dec 20, 2020
Adp of the SNF Dec 21, 2020
Organization, Dunmore, PA Corporation, For-profit Adp of the SNF Apr 7, 2025
Organization, Manalapan, NJ LLC, Consulting firm, For-profit Adp of the SNF Feb 27, 2025
Organization, Scranton, PA LLC, For-profit Adp of the SNF May 9, 2025
Kathleen Hentschel Individual Operational/Managerial Control Mar 29, 2021
Adp of the SNF Mar 29, 2021
Organization, Scranton, PA LLC, For-profit Adp of the SNF May 9, 2025
Heather L Rogers Individual Operational/Managerial Control Jun 24, 2024
Adp of the SNF Jun 24, 2024
Individual Direct Ownership Interest Apr 8, 2025
Indirect Ownership Interest Apr 8, 2025
Individual Adp of the SNF Mar 1, 2025
Eaz Operating Company, LLC Organization, Scranton, PA LLC, For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 35%
Brenda L Lederer Individual Operational/Managerial Control Jun 1, 2022
Adp of the SNF Jun 1, 2022
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 Apr 8, 2025
Organization, Beachwood, OH Adp of the SNF Mar 28, 2023
Kaitlin H Estell Individual Operational/Managerial Control Jun 27, 2022
Adp of the SNF Jun 27, 2022
George S. Repchick 2020 Family Dynasty Trust Organization, Shaker Heights, OH For-profit 5% Or Greater Indirect Ownership Interest Mar 28, 2023 30%
Indirect Ownership Interest Mar 28, 2023 30%
Organization, Scranton, PA LLC, For-profit Adp of the SNF May 9, 2025
Individual Adp of the SNF Mar 1, 2025
Catherine M Malloy Individual Operational/Managerial Control Apr 29, 2024
Adp of the SNF Apr 29, 2024
Michael J Falco Individual Operational/Managerial Control Aug 15, 2023
Adp of the SNF Aug 15, 2023
Organization, Scranton, PA LLC, Holding company, For-profit Adp of the SNF Mar 28, 2023
Organization, Scranton, PA LLC, For-profit Adp of the SNF Mar 28, 2023
Help for the Kids, LLC Organization, Scranton, PA LLC, For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 35%
Organization, Woodmere, OH For-profit Adp of the SNF Apr 7, 2025
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%
Organization, Scranton, PA LLC, For-profit Adp of the SNF Mar 28, 2023
Individual Adp of the SNF Mar 1, 2025
Tracy L Palovitz Individual Operational/Managerial Control Jul 12, 2021
Adp of the SNF Jul 12, 2021
2020 GSR Dynasty LLC Organization, Beachwood, OH LLC, For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 28, 2023 30%
Individual Direct Ownership Interest Apr 8, 2025
Indirect Ownership Interest Apr 8, 2025

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 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1043809577",
    "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": "111 RIVERS EDGE DR",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183362057",
            "telephone_number": "570-491-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE VALLEY SKILLED NURSING OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "KEEFER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "570-969-2188"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delaware Valley Skilled Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matamoras, PA

Sources for this page

Verify at the official NPI Registry.