Vernon Manor SNF Operations LLC
Organization Active NPI Skilled Nursing Facility · Vernon, CT
NPI 1053045294 · NPPES record last updated Jul 13, 2022
Key facts
- NPI
- 1053045294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- VERNON MANOR SNF OPERATIONS LLC
- Practice address
- 180 Regan Rd
Vernon, CT 06066-2824 - Phone
- (860) 871-0385
- NPI assigned
- Jul 13, 2022
- Organization subpart
- No
Authorized official
- Name
- Pinchos Bak
- Title
- Authorized Representative
- Phone
- (908) 783-3110
Owners & managing parties with NPI records 1
-
Kristin Giannini, M.D.
Facilities with the same owner 18
Affiliated clinicians 1
-
Kristin Giannini, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Vernon Rehabilitation and Healthcare Center
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★★ 5 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 17, 1990
- Medicare certification status
- Active
- Certified beds
- 120 · 115.1 residents per day on average
- Chain
- Atlas Healthcare
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D0093268 | Vernon Manor SNF Operations LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Skilled nursing facility certification: CCN 075334
- Legal name
- VERNON MANOR SNF OPERATIONS LLC
- Doing business as
- VERNON REHABILITATION AND HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 17, 1990
- Last certification
- Oct 11, 2024
- Beds
- 120
- Ownership / control type
- Corporation
- Multi-facility organization
- ATLAS HEALTHCARE
- Most recent change of ownership
- Jul 27, 2022
- Organization structure
- LLC · Proprietary
- Enrollment address
- 180 Regan Rd
Vernon, CT 06066-2824 - Nursing home name
- VERNON REHABILITATION AND HEALTHCARE CENTER
- Affiliated entity
- ATLAS HEALTHCARE
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Tyh 2017 Trust |
Limited Partnership Interest | Jul 27, 2022 | |
| Vernon Manor SNF Realty LLC |
Adp of the SNF | Jul 15, 2025 | |
| Kristi Dougherty |
Operational/Managerial Control | Jul 27, 2022 | |
| Adp of the SNF | Jul 27, 2022 | ||
| Shlomo Goldberger |
Operational/Managerial Control | Jul 27, 2022 | |
| Adp of the SNF | Jul 27, 2022 | ||
| JS Evans Investments LLC |
Limited Partnership Interest | Jul 27, 2022 | |
| JMH Family Trust |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 22.8% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| CT-3 Operations Holdings LLC |
5% Or Greater Direct Ownership Interest | Jul 27, 2022 | 100% |
| |
Trustee of the SNF | Jul 27, 2022 | |
| Tamlyn Campanelli |
Operational/Managerial Control | Jul 27, 2022 | |
| Adp of the SNF | Jul 27, 2022 | ||
| Pinchos Z Bak |
Corporate Officer |
Jul 27, 2022 | |
| Operational/Managerial Control | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| Moshe Gottlieb |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 24% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Operational/Managerial Control | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| Kristin Giannini |
Operational/Managerial Control | Jul 27, 2022 | |
| Adp of the SNF | Jul 27, 2022 | ||
| MLS Family LLC |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 24% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| |
Trustee of the SNF | Jul 27, 2022 | |
| SGS Family LLC |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 24% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| MLS Family Trust |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 22.8% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| CT-3 Opco Manager LLC |
Operational/Managerial Control | Jul 27, 2022 | |
| Adp of the SNF | Jul 15, 2025 | ||
| JMH Family LLC |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 24% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| SGS Family Trust |
5% Or Greater Indirect Ownership Interest | Jul 27, 2022 | 22.8% |
| Limited Partnership Interest | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| Moshe Sonnenschein |
Operational/Managerial Control | Jul 27, 2022 | |
| Trustee of the SNF | Jul 27, 2022 | ||
| Adp of the SNF | Jul 27, 2022 | ||
| SGS 2010 Family Trust |
Limited Partnership Interest | Jul 27, 2022 | |
| Av SNF Realty Holdings LLC |
Adp of the SNF | Jul 27, 2022 | |
| |
Trustee of the SNF | Jul 27, 2022 | |
| Malt Family Trust |
Limited Partnership Interest | Jul 27, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220914003259 | CT | Part a Provider - Skilled Nursing Facility | 8022493824 | Practice locations: Vernon, CT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
180 Regan Rd
Vernon, CT 06066-2824
Mailing address
180 Regan Rd
Vernon, CT 06066-2824
Other providers in Vernon, CT
- Jennifer Vanveen
- Charles A Vassilopoulos
- Vcare Family Practice, LLC
- Vernon Family Dentists
- Vernon Manor Health Care Center, LLC
- Vernon Public Schools
- Vernon Urgent Care Center, LLC
- Sabitha Vignesh
- Debra Ann Vinick
- Peter N Visgilio
All providers in Vernon, CT · Skilled Nursing Facility in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2022. 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.