NPIMap

Organization Active NPI

Landmark of Laurel Creek Rehabilitation and Nursing Center

  • Skilled Nursing Facility
  • Manchester, KY
National Provider Identifier
1053809012
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LANDMARK OF LAUREL CREEK REHABILITATION AND NURSING CENTER
Practice address
1033 N Highway 11
Manchester, KY 40962-5478
Phone
(606) 598-6163
NPI assigned
Apr 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Joseph Meisels
Title
Manager
Phone
(269) 281-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1033 N Highway 11
Manchester, KY 40962-5478

Mailing address

6101 Nimtz Pkwy
South Bend, IN 46628-6111
Phone (269) 281-4200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181220002309 KY Part A Provider - Skilled Nursing Facility 6406191378 Practice locations: Manchester, KY

Skilled nursing facility certification: CCN 185293

Legal name
LANDMARK OF LAUREL CREEK REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 15, 1991
Last certification
Jun 24, 2021
Beds
106
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Lyon Healthcare
Organization structure
LLCProprietary
Enrollment address
1033 N Highway 11
Manchester, KY 40962-5478
Nursing home name
LANDMARK OF LAUREL CREEK REHABILITATION AND NURSING CENTER, LLC
Affiliated entity
LYON HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Landmark of Laurel Creek Rehabilitation and NursinCCN 185293
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 15, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10694.2 residents per day on average
Chain
Lyon Healthcare11 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
18D0884749Landmark of Laurel Creek Rehabilitation1033 North Highway 11, Manchester, KY 40962Certificate of waiverApr 8, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
A&M Healthcare Investments LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2018 100%
Susan Bush Individual W-2 Managing Employee May 1, 2018
Joseph Meisels Individual Corporate Officer May 1, 2018

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 4

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

Affiliated clinicians 4

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": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1053809012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 NIMTZ PKWY",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466286111",
            "telephone_number": "269-281-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 N HIGHWAY 11",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409625478",
            "telephone_number": "606-598-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK OF LAUREL CREEK REHABILITATION AND NURSING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "MEISELS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "269-281-4200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

Verify at the official NPI Registry.