El Cajon Post Acute, LLC
Organization Active NPI Skilled Nursing Facility · El Cajon, CA
NPI 1063974285 · NPPES record last updated Aug 19, 2024
Key facts
- NPI
- 1063974285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- EL CAJON POST ACUTE, LLC
- Practice address
- 1580 Broadway
El Cajon, CA 92021-5124 - Phone
- (619) 441-8745
- NPI assigned
- Apr 5, 2019
- Organization subpart
- No
Authorized official
- Name
- John Mitchell
- Title
- Secretary
- Phone
- (385) 988-3319
Owners & managing parties with NPI records 1
-
Bernard Aron Michlin, M.D.
Facilities with the same owner 186
Affiliated clinicians 6
-
Ali Ghazi Alamar, M.D.
-
Anthony Farid Fam, M.D.
-
Bernard Aron Michlin, M.D.
-
Robert H. Moon, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Country Hills Post Acute
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 3, 1990
- Medicare certification status
- Active
- Certified beds
- 305 · 292.8 residents per day on average
- Chain
- Pacs Group
- Penalties (3 years)
- 1 · fines totaling $122,210
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0893439 | Country Hills Post Acute | Certificate of waiver | Oct 21, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 555431
- Legal name
- EL CAJON POST ACUTE LLC
- Doing business as
- COUNTRY HILLS POST ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 3, 1990
- Last certification
- Mar 14, 2025
- Beds
- 305
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 17, 2018 in CA
- Enrollment address
- 1580 Broadway
El Cajon, CA 92021-5124 - Nursing home name
- COUNTRY HILLS POST ACUTE
- Affiliated entity
- PACS GROUP
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Jason H Murray |
5% Or Greater Indirect Ownership Interest | Apr 15, 2024 | 41.8% |
| John T Mitchell |
Corporate Officer |
Jan 1, 2024 | |
| Zachary T Graf |
W-2 Managing Employee |
Apr 1, 2024 | |
| Frederick G Apt |
Corporate Officer |
Jan 1, 2024 | |
| Providence Group NH, LLC |
5% Or Greater Direct Ownership Interest | Jun 30, 2023 | 100% |
| Pacs Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Joshua O Jergensen |
Corporate Officer |
Jan 1, 2024 | |
| Bernard Aron Michlin |
Contracted Managing Employee |
Apr 1, 2019 | |
| Pacs Group, Inc. |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Mark D Hancock |
5% Or Greater Indirect Ownership Interest | Apr 15, 2024 | 41.8% |
| Corporate Officer |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190605001106 | CA | Part a Provider - Skilled Nursing Facility | 6406189547 | Practice locations: El Cajon, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1580 Broadway
El Cajon, CA 92021-5124
Mailing address
262 N University Ave
Farmington, UT 84025-2975
Other names
- Country Hills Post Acute
Other providers in El Cajon, CA
- Catherine William Faltaos Ekladios
- El Cajon Elder Care, LLC
- El Cajon Laboratory Services Inc
- El Cajon Pediatric Medical Group
- El Cajon Physical Therapy Apc
- El Cajon Therapy Associates
- El Cajon Therapy Associates, Inc
- El Cajon X-Ray Imaging
- El Nudo, LLC
- Ahmed El-Ghoneimy
All providers in El Cajon, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2024. 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.