NPIMap

Organization Active NPI

Garden Village

  • Skilled Nursing Facility
  • Yakima, WA
National Provider Identifier
1093763393
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH1242 Issued in WA
Legal business name
GARDEN VILLAGE
Practice address
206 S 10TH Ave
Yakima, WA 98902
Phone
(509) 453-4854
Fax
(509) 453-2196
NPI assigned
May 5, 2006
Last updated
Nov 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Cheryl Kubu, NHA
Title
Administrator
Phone
(509) 999-3345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH1242 WA Primary

Addresses

Primary practice location

206 S 10TH Ave
Yakima, WA 98902

Mailing address

206 S 10TH Ave
Yakima, WA 98902
Phone (509) 453-4854

Other identifiers 1

IdentifierTypeStateIssuer
4113163MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101103000814 WA Part A Provider - Skilled Nursing Facility 5395939342 Practice locations: Yakima, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093763393. Details of each certification follow.

Skilled nursing facility certification: CCN 505010

Legal name
GARDEN VILLAGE
Doing business as
GARDEN VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Oct 29, 2024
Beds
101
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Enrollment address
206 S 10TH Ave
Yakima, WA 98902-3321
Nursing home name
GARDEN VILLAGE
Affiliated entity
AVALON HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Garden VillageCCN 505010 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10187.6 residents per day on average
Chain
Avalon Health Care16 facilities in the chain
Penalties (3 years)
3Fines totaling $74,671

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
50D0923282Garden Village206 S 10TH Avenue, Yakima, WA 98902Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

206 S 10th Ave
Yakima, WA 98902
Phone (509) 453-4564

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Yakima Associates LP Organization, Los Angeles, CA Adp of the SNF Jun 14, 1996
Avalon Health Care Management Inc Organization, Salt Lake City, UT Corporation, Management services company, For-profit Operational/Managerial Control Jun 12, 2025
Adp of the SNF Nov 10, 2025
Laura Stengel Individual Managing Control - Governing BodyBoard Director Sep 1, 2025
Avalon Care Center - Yakima LLC Organization, Salt Lake City, UT LLC, Management services company Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024
Nicole Smith Individual Operational/Managerial Control Jun 12, 2025
Adp of the SNF Jun 12, 2025
Lynn Siedenstrang Individual Operational/Managerial Control May 1, 2023
Managing Control - Governing BodyBoard Chairman May 1, 2023
Yakima Valley Memorial Hospital Association Organization, Yakima, WA Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2025 100%
Maxwell Owens Individual Managing Control - Governing BodyBoard Memeber Jul 1, 2024
Maria Borisevich Individual Operational/Managerial Control Jun 12, 2025
Adp of the SNF Jun 12, 2025
Multicare Health System Organization, Tacoma, WA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2010 100%
Brooks Watson Individual Operational/Managerial Control Aug 1, 2025
Adp of the SNF Aug 1, 2025
Helen Wilson Individual Operational/Managerial Control Jul 7, 2025
Adp of the SNF Jul 7, 2025
Alan B Hash Individual Corporate OfficerCeo Oct 1, 2024
Operational/Managerial Control Jun 12, 2025
Adp of the SNF Jun 12, 2025
Miguel Castaneda Avila Individual Operational/Managerial Control Apr 7, 2025
Adp of the SNF Apr 7, 2025

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 6

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 2

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": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1093763393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S 10TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-453-4854",
            "fax_number": "509-453-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S 10TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-453-4854",
            "fax_number": "509-453-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "KUBU",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-999-3345",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH1242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113163",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.