NPIMap

Organization Active NPI

Maplewood Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Maplewood, MN
National Provider Identifier
1053189506
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAPLEWOOD REHABILITATION CENTER LLC
Practice address
1900 Sherren Ave E
Maplewood, MN 55109-2803
Phone
(651) 770-1365
NPI assigned
Dec 14, 2023
Last updated
Dec 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Joshua Legum
Title
President
Phone
(507) 203-1001

Specialties & licenses 1

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

Addresses

Primary practice location

1900 Sherren Ave E
Maplewood, MN 55109-2803

Mailing address

1345 Corporate Center Curv
Eagan, MN 55121-1295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240323000012 MN Part A Provider - Skilled Nursing Facility 3476990664 Practice locations: Maplewood, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053189506. Details of each certification follow.

Skilled nursing facility certification: CCN 245276

Legal name
MAPLEWOOD REHABILITATION CENTER LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1985
Last certification
Nov 7, 2024
Beds
115
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Monarch Healthcare Management
Organization structure
LLCProprietary
Incorporated
Nov 15, 2023 in MN
Enrollment address
1900 Sherren Ave E
Maplewood, MN 55109-2803
Nursing home name
MAPLEWOOD REHABILITATION CENTER
Affiliated entity
MONARCH HEALTHCARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Maplewood Rehabilitation CenterCCN 245276 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
115102.7 residents per day on average
Chain
Monarch Healthcare Management45 facilities in the chain

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
24D0669532Maplewood Rehabilitation Center1900 Sherren Ave, Maplewood, MN 55109Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Spartan Healthcare LLC Organization, Chicago, IL LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 32%
WBS Holdings LLC Organization, Brooklyn, NY LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 26%
Monarch Healthcare Operating Xiv LLC Organization, Mankato, MN LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 31, 2023 100%
William Stern Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 26%
Corporate OfficerChief Financial Officer Dec 31, 2023 26%
Marc Halpert Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 32%
Corporate OfficerCeo Dec 31, 2023 32%
Operational/Managerial Control Dec 31, 2023 32%
Mackenzie Goodreid Individual W-2 Managing EmployeeAdministrator Feb 21, 2024 1%
Joshua Legum Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 26%
Yazoma Holdings, LLC Organization, Fort Lauderdale, FL LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 26%
Joseph Greenberg Individual Contracted Managing EmployeeMedical Director Dec 31, 2023 5%
Noam Jaffa Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 16%
Corporate DirectorDirector of Procurement Dec 31, 2023 16%
Nij LLC Organization, St Louis Park, MN LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 16%

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 44

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

View all 44

Practitioners & affiliated clinicians

Practitioners 3

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 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": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1053189506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 CORPORATE CENTER CURV",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SHERREN AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092803",
            "telephone_number": "651-770-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-203-1001"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.