NPIMap

Organization Active NPI

Mulberry Healthcare Operating LLC

  • Skilled Nursing Facility
  • Punxsutawney, PA
National Provider Identifier
1083344998
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MULBERRY HEALTHCARE OPERATING LLC
Practice address
411 W Mahoning St
Punxsutawney, PA 15767-1907
Phone
(814) 938-6020
NPI assigned
Jun 14, 2022
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Mike Zidele
Title
Cfo
Phone
(716) 374-2526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

411 W Mahoning St
Punxsutawney, PA 15767-1907

Mailing address

411 W. Mahoning Street
Punxsutawney, PA 15767-0000

Other names 1

  • Bonamour Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220907000527 PA Part A Provider - Skilled Nursing Facility 6800270026 Practice locations: Punxsutawney, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083344998. Details of each certification follow.

Skilled nursing facility certification: CCN 395618

Legal name
MULBERRY HEALTHCARE OPERATING, LLC
Doing business as
MULBERRY HEALTHCARE AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1984
Last certification
Oct 18, 2024
Beds
75
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
May 13, 2022 in DE
Enrollment address
411 1/2 West Mahoning Street
Punxsutawney, PA 15767-1907
Nursing home name
ASPEN NURSING AND REHAB CENTER
Affiliated entity
BONAMOUR HEALTH GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Aspen Nursing and Rehab CenterCCN 395618 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7553.5 residents per day on average
Chain
Bonamour Health Group5 facilities in the chain
Penalties (3 years)
1Fines totaling $24,042

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Yeshayahu Zidele Individual 5% Or Greater Direct Ownership Interest Jun 28, 2022 50%
Adp of the SNF Jun 28, 2022
Indirect Ownership Interest Jun 28, 2022 50%
Laura Deet Individual Operational/Managerial Control Jun 28, 2022
Adp of the SNF Jun 28, 2022
Bonamour Health Group LLC Organization, Punxsutawney, PA LLC, For-profit Operational/Managerial Control Nov 12, 2024 100%
Adp of the SNF Feb 27, 2025
Brandon M Roscoe Individual Adp of the SNF Jun 28, 2022
Mordechai Zidele Individual 5% Or Greater Direct Ownership InterestCfo Jun 28, 2022 50%
Adp of the SNF Jun 28, 2022
Direct Ownership Interest Jun 28, 2022

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 3

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

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 1

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": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1083344998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W. MAHONING STREET",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157670000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W MAHONING ST",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157671907",
            "telephone_number": "814-938-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY HEALTHCARE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "ZIDELE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "716-374-2526"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonamour",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bonamour",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Punxsutawney, PA

Sources for this page

Verify at the official NPI Registry.