NPIMap

Organization Active NPI

San Gabriel Healthcare & Wellness Centre, LP

Doing business as Ivy Creek Healthcare & Wellness Centre

  • Skilled Nursing Facility
  • San Gabriel, CA
National Provider Identifier
1063773075
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
950000007 Issued in CA
Legal business name
SAN GABRIEL HEALTHCARE & WELLNESS CENTRE, LP
Doing business as
Ivy Creek Healthcare & Wellness Centre
Practice address
115 Bridge St
San Gabriel, CA 91775-2719
Phone
(626) 289-4439
Fax
(626) 289-0056
NPI assigned
Jun 6, 2012
Last updated
Jun 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
Shlomo Rechnitz
Title
Manager
Phone
(626) 800-1191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 950000007 CA Primary

Addresses

Primary practice location

115 Bridge St
San Gabriel, CA 91775-2719

Mailing address

115 Bridge St
San Gabriel, CA 91775-2719
Phone (626) 289-4439

Other identifiers 1

IdentifierTypeStateIssuer
LTC08441FMedicaidCA

Other names 1

  • Ivy Creek Healthcare & Wellness Centre Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120820001020 CA Part A Provider - Skilled Nursing Facility 3678720091 Practice locations: San Gabriel, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063773075. Details of each certification follow.

Skilled nursing facility certification: CCN 055441

Legal name
SAN GABRIEL HEALTHCARE & WELLNESS CENTRE LP
Doing business as
IVY CREEK HEALTHCARE & WELLNESS CENTRE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Apr 10, 2025
Beds
98
Ownership / control type
Limited Liability Corporation
Organization structure
PartnershipProprietary
Incorporated
May 25, 2012 in CA
Enrollment address
115 Bridge St
San Gabriel, CA 91775-2719
Nursing home name
IVY CREEK HEALTHCARE & WELLNESS CENTRE
Affiliated entity
CORPORATE INTERFACE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ivy Creek Healthcare & Wellness CentreCCN 055441 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9892.7 residents per day on average
Chain
Corporate Interface Services40 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
05D2051045Ivy Creek Healthcare & Wellness Centre115 Bridge St., San Gabriel, CA 91775Certificate of waiverDec 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Alderwood Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Rockport Administrative Services, LLC Organization, Los Angeles, CA LLC Operational/Managerial Control Jun 1, 2012
Adp of the SNF Jun 1, 2012
Eretz Ivy Creek Properties LLC Organization, Los Angeles, CA LLC Adp of the SNF Aug 1, 2012
Candace Yu Individual Operational/Managerial Control Jan 3, 2022
Adp of the SNF Jan 3, 2022
Bosheng Qiu Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Jonathan Weiss Individual Limited Partnership InterestLimited Partner Jun 1, 2012 3.5%
G4 Wellness GP LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual General Partnership Interest Jun 1, 2012 0.1%
Shlomo Rechnitz Individual Limited Partnership InterestLimited Partner Jun 1, 2012 96.4%

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 70

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

View all 70

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1063773075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BRIDGE ST",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752719",
            "telephone_number": "626-289-4439",
            "fax_number": "626-289-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRIDGE ST",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752719",
            "telephone_number": "626-289-4439",
            "fax_number": "626-289-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL HEALTHCARE & WELLNESS CENTRE, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "RECHNITZ",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "626-800-1191"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "950000007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC08441F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ivy Creek Healthcare & Wellness Centre",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ivy Creek Healthcare & Wellness Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.