Active NPI
Solheim Lutheran Home
- Skilled Nursing Facility
- Los Angeles, CA
National Provider Identifier
1114901741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- CA970000049
- Legal business name
- SOLHEIM LUTHERAN HOME
- Practice address
- 2236 Merton Ave
Los Angeles, CA 90041-1915 - Phone
- (323) 257-7518
- Fax
- (323) 255-3544
- NPI assigned
- Dec 6, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Graunke, NHA
- Title
- Executive Director
- Phone
- (323) 257-7518
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | CA970000049 | CA | Primary |
Addresses
Primary practice location
2236 Merton Ave
Los Angeles, CA 90041-1915
Mailing address
2236 Merton Ave
Los Angeles, CA 90041-1915
Phone (323) 257-7518
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT18598F | Medicaid | CA |
Other names 1
- Solheim Senior Community
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060216000513 | CA | Part A Provider - Skilled Nursing Facility | 6800801507 | Practice locations: Los Angeles, CA |
Skilled nursing facility certification: CCN 555432
- Legal name
- SOLHEIM LUTHERAN HOME
- Doing business as
- SOLHEIM SENIOR COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 15, 1990
- Last certification
- Oct 11, 2024
- Beds
- 76
- Ownership / control type
- Other Nonprofit
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1954 in CA
- Enrollment address
- 2236 Merton Ave
Los Angeles, CA 90041-1915 - Nursing home name
- SOLHEIM SENIOR COMMUNITY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Solheim Senior Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- May 15, 1990
- Medicare certification status
- Active
- Certified beds
- 76
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0642477 | Solheim Lutheran Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 17
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Charles Killian | Operational/Managerial Control | Jun 11, 2023 | |
| Adp of the SNF | Jun 11, 2023 | ||
| Joseph Johnson | Operational/Managerial Control | Jun 9, 2024 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Susan Stark | Corporate Director | Oct 12, 2014 | |
| Adp of the SNF | Nov 1, 2020 | ||
| Paul Egge | Corporate Director | Jun 1, 2022 | |
| Operational/Managerial Control | Jun 10, 2018 | ||
| Adp of the SNF | Jun 10, 2018 | ||
| Adria E. Navarro | Corporate Director | Jun 1, 2022 | |
| Operational/Managerial Control | Jun 5, 2022 | ||
| Adp of the SNF | Jun 5, 2022 | ||
| Solheim Lutheran Home | Operational/Managerial Control | Jun 25, 1966 | |
| CL Keedy | Corporate Director | Nov 1, 2020 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Samuel T Oden | Corporate Officer | Jan 1, 2020 | |
| Garry Mohr | Operational/Managerial Control | Jun 9, 2024 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Kenneth Kallman | Corporate Director | Jun 1, 2021 | |
| Adp of the SNF | Jun 13, 2021 | ||
| Susan Auer | Operational/Managerial Control | Jun 11, 2023 | |
| Indirect Ownership Interest | Jun 11, 2023 | ||
| Meg E Pierce | Operational/Managerial Control | Aug 24, 2020 | |
| Frederick Garcia | Operational/Managerial Control | Jun 9, 2024 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Thomas Cox | Operational/Managerial Control | Jun 9, 2024 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Ekik Magardornyan | Operational/Managerial Control | Jun 9, 2024 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Robert Gerringer | Corporate Director | Jul 1, 2021 | |
| Adp of the SNF | Jun 13, 2021 | ||
| Brenda Bos | Corporate Director | Jun 1, 2022 | |
| Operational/Managerial Control | Jun 5, 2022 | ||
| Adp of the SNF | Jun 5, 2022 |
Practitioners & affiliated clinicians
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Pasadena, CA
- NPI 1235460510
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1114901741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2236 MERTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900411915",
"telephone_number": "323-257-7518",
"fax_number": "323-255-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2236 MERTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900411915",
"telephone_number": "323-257-7518",
"fax_number": "323-255-3544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOLHEIM LUTHERAN HOME",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-06",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "GRAUNKE",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "323-257-7518",
"authorized_official_credential": "NHA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "CA970000049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT18598F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Solheim Senior Community",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.