NPIMap

Organization Active NPI

Spring Valley Post Acute LLC

  • Skilled Nursing Facility
  • Victorville, CA
National Provider Identifier
1053748830
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SPRING VALLEY POST ACUTE LLC
Practice address
14973 Hesperia Rd
Victorville, CA 92395-3923
Phone
(310) 266-1080
Fax
(714) 256-2003
NPI assigned
Oct 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Authorized official

Name
Mr. David Johnson
Title
Ceo
Phone
(310) 266-1080

Specialties & licenses 1

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

Addresses

Primary practice location

14973 Hesperia Rd
Victorville, CA 92395-3923

Mailing address

530 N Puente St
Brea, CA 92821-2804
Phone (310) 266-1080

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05076FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140207000501 CA Part A Provider - Skilled Nursing Facility 7315176682 Practice locations: Victorville, CA

Skilled nursing facility certification: CCN 055076

Legal name
SPRING VALLEY POST ACUTE LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 19, 1971
Last certification
Nov 21, 2024
Beds
126
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Meridian Management Services LLC
Organization structure
LLCProprietary
Incorporated
Oct 8, 2013 in AR
Enrollment address
14973 Hesperia Rd
Victorville, CA 92395-3923
Nursing home name
SPRING VALLEY POST ACUTE LLC
Affiliated entity
DAVID JOHNSON

Care Compare: Nursing home

Medicare Care Compare
Listed as
Spring Valley Post Acute LLCCCN 055076
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 19, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
126110.7 residents per day on average
Chain
David Johnson48 facilities in the chain
Penalties (3 years)
11Fines totaling $57,810

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Meridian Management Services LLC Organization, Brea, CA Operational/Managerial Control Dec 20, 2013 100%
David a Johnson Individual Operational/Managerial Control Oct 8, 2013
Direct Ownership Interest Oct 8, 2013 50%
Hari Naraya Reddy Individual Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Thomas M Chambers Individual Operational/Managerial Control Oct 8, 2013
Adp of the SNF Oct 8, 2013
Direct Ownership Interest Oct 8, 2013 50%
Spring Valley Post Acute LLC Organization, Victorville, CA LLC Operational/Managerial Control Dec 20, 2013
Adp of the SNF Sep 15, 2025
Preyas Soni Individual Operational/Managerial Control Jul 16, 2023
Adp of the SNF Jul 16, 2023

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1053748830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N PUENTE ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928212804",
            "telephone_number": "310-266-1080",
            "fax_number": "714-256-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14973 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953923",
            "telephone_number": "310-266-1080",
            "fax_number": "714-256-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING VALLEY POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-266-1080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05076F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.