NPIMap

Organization Active NPI

A.V.C.H., Inc.

Doing business as Apple Valley Post-Acute Rehab

  • Skilled Nursing Facility
  • Sebastopol, CA
National Provider Identifier
1114902616
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
010000016 Issued in CA
Legal business name
A.V.C.H., INC.
Doing business as
Apple Valley Post-Acute Rehab
Practice address
1035 Gravenstein Hwy S
Sebastopol, CA 95472-4538
Phone
(707) 823-7675
NPI assigned
Dec 7, 2005
Last updated
Apr 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Marc Johnson
Title
Cfo
Phone
(949) 373-8373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 010000016 CA Primary

Addresses

Primary practice location

1035 Gravenstein Hwy S
Sebastopol, CA 95472-4538

Mailing address

25910 Acero Ste 350
Mission Viejo, CA 92691-7908
Phone (949) 441-9258

Other identifiers 1

IdentifierTypeStateIssuer
ZZR05919HMedicaidCA

Other names 1

  • APPLE VALLEY POST-ACUTE REHAB Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111220000242 CA Part A Provider - Skilled Nursing Facility 6103092291 Practice locations: Sebastopol, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114902616. Details of each certification follow.

Skilled nursing facility certification: CCN 055919

Legal name
A.V.C.H., INC.
Doing business as
APPLE VALLEY POST-ACUTE REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1968
Last certification
Nov 8, 2024
Beds
95
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 21, 1995 in NV
Enrollment address
1035 Hwy 116 S
Sebastopol, CA 95472-4865
Nursing home name
APPLE VALLEY POST-ACUTE REHAB
Affiliated entity
NAHS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Apple Valley Post-Acute RehabCCN 055919 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9583.0 residents per day on average
Chain
Nahs12 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
05D0612311Apple Valley Post - Acute Rehab1035 Gravenstein Hway S, Sebastopol, CA 95472Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1035 Hwy 116 N
Sebastopol, CA 95472

1035 Hwy 116 S
Sebastopol, CA 95472
Phone (707) 823-7675

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Nahs Employee Stock Ownership Trust Organization, Mission Viejo, CA 5% Or Greater Indirect Ownership Interest Jun 30, 2018 100%
Mark Walton Individual Corporate OfficerSecretary Jun 29, 2018
Corporate DirectorDirector Jun 29, 2018
James Barlow Individual Corporate DirectorDirector Jun 29, 2018
Timothy J Paulsen Individual Corporate DirectorChairperson of the Board Jun 29, 2018
Noel Serrano Individual Operational/Managerial Control Apr 1, 2016
Adp of the SNF Apr 1, 2016
Michael J Moore Individual Corporate OfficerPresident Feb 1, 2022
Corporate DirectorDirector Feb 1, 2022
Nahs Holding Inc Organization, Mission Viejo, CA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2018 100%
Brent Marshall Individual Corporate OfficerPresident/Administrator Oct 18, 2024
Corporate DirectorPresident/Administrator Oct 18, 2024
Operational/Managerial Control Oct 18, 2024
Managing Control - Governing BodyCorporate Director Oct 18, 2024
Adp of the SNF Oct 18, 2024
Nahs North Inc Organization, Mission Viejo, CA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2018 100%
Victor G Lundquist Individual Corporate OfficerSecretary Mar 21, 2018
Organization, Mission Viejo, CA Indirect Ownership Interest Jun 30, 2018 100%
Joanne Lane Individual Corporate DirectorDirector Feb 1, 2023
Managing Control - Governing BodyCorporate Director Feb 1, 2023
Marc Johnson Individual Corporate OfficerTreasurer Nov 20, 2022
Adp of the SNF Nov 20, 2022
Organization, Stockton, CA Adp of the SNF Apr 21, 1995
Ralph Baja Individual Corporate DirectorDirector Jul 1, 2023

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 10

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

Practitioners & affiliated clinicians

Practitioners 10

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": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1114902616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25910 ACERO STE 350",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917908",
            "telephone_number": "949-441-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 GRAVENSTEIN HWY S",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724538",
            "telephone_number": "707-823-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.V.C.H., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-373-8373"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "010000016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05919H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "APPLE VALLEY POST-ACUTE REHAB",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "APPLE VALLEY POST-ACUTE REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebastopol, CA

Sources for this page

Verify at the official NPI Registry.