CF Susanville, LLC
Organization Active NPI Skilled Nursing Facility · Susanville, CA
NPI 1124170519 · NPPES record last updated Feb 9, 2015
Key facts
- NPI
- 1124170519
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 230000058 (CA)
- Legal business name
- CF SUSANVILLE, LLC
- Practice address
- 2005 River Street
Susanville, CA 96130 - Phone
- (530) 257-5341
- Fax
- (530) 257-8150
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Jacob Wintner
- Title
- Manager
- Phone
- (323) 651-1808
Owners & managing parties with NPI records 1
-
Aishwarya Sharma, DO
Facilities with the same owner 32
Affiliated clinicians 4
-
James E Hunt, M.D.
-
Kenneth G Korver, M.D.
-
Aishwarya Sharma, DO
Medicare Care Compare: Nursing home
- Listed as
- Lassen Nursing & Rehabilitation Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 10, 1970
- Medicare certification status
- Active
- Certified beds
- 96 · 83.5 residents per day on average
- Chain
- Cambridge Healthcare Services
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0671777 | CF Susanville, LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 056231
- Legal name
- CF SUSANVILLE LLC
- Doing business as
- LASSEN NURSING & REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 10, 1970
- Last certification
- Oct 24, 2024
- Beds
- 96
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Feb 1, 2007
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 17, 2006 in CA
- Enrollment address
- 2005 River St
Susanville, CA 96130-4524 - Nursing home name
- LASSEN NURSING & REHABILITATION CENTER
- Affiliated entity
- CAMBRIDGE HEALTHCARE SERVICES
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| Bering Properties LLC |
5% Or Greater Indirect Ownership Interest | Feb 1, 2007 | 6% |
| BH Alliance |
Indirect Ownership Interest | Nov 1, 2006 | 4% |
| Manhattan Five Partners LLC |
5% Or Greater Indirect Ownership Interest | Nov 1, 2006 | 6.52% |
| Linda Lutz |
Operational/Managerial Control | Feb 1, 2012 | |
| Adp of the SNF | Feb 1, 2012 | ||
| Gregory Bretsch |
Operational/Managerial Control | Feb 25, 2019 | |
| Managing Control - Governing Body |
Feb 25, 2019 | ||
| Adp of the SNF | Feb 25, 2019 | ||
| Win Win Enterprises, LLC |
5% Or Greater Indirect Ownership Interest | Feb 1, 2007 | 35% |
| Adp of the SNF | Feb 1, 2007 | ||
| Aishwarya Sharma |
Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Nov 1, 2025 | ||
| Lance a Hassell |
Operational/Managerial Control | Apr 25, 2022 | |
| Adp of the SNF | Apr 25, 2022 | ||
| Cambridge Healthcare Services LLC |
Operational/Managerial Control | Apr 1, 2014 | |
| Adp of the SNF | Jul 17, 2025 | ||
| Ira Smedra |
5% Or Greater Indirect Ownership Interest |
Feb 1, 2007 | 5.75% |
| Corporate Officer |
Feb 1, 2007 | 50% | |
| Operational/Managerial Control |
Jan 1, 2007 | ||
| Adp of the SNF | Feb 1, 2007 | ||
| Melissa Swartz |
Operational/Managerial Control | Jul 2, 2019 | |
| The Jacob Wintner Trust |
Indirect Ownership Interest | Nov 1, 2006 | 2% |
| Lorrie Fitzgerald |
Operational/Managerial Control | Feb 4, 2024 | |
| Managing Control - Governing Body |
Feb 4, 2024 | ||
| Adp of the SNF | Jul 16, 2025 | ||
| Jenmax Enterprises LLC |
5% Or Greater Indirect Ownership Interest | Feb 1, 2007 | 23% |
| Adp of the SNF | Feb 1, 2007 | ||
| JK-CSH JV LLC |
5% Or Greater Indirect Ownership Interest | Nov 1, 2006 | 12% |
| Adp of the SNF | Nov 1, 2006 | ||
| Jacob Wintner |
Corporate Officer |
Feb 1, 2007 | 50% |
| Operational/Managerial Control |
Feb 1, 2007 | ||
| Jacob Wintner |
Adp of the SNF | Feb 1, 2007 | |
| Indirect Ownership Interest | Feb 1, 2007 | 3% | |
| The Wintner Living Trust Dated 7/08/1992 |
Indirect Ownership Interest | Feb 1, 2007 | 1% |
| Paulina Salazar |
Operational/Managerial Control | Dec 14, 2020 | |
| Adp of the SNF | Dec 14, 2020 | ||
| 2005 River, LLC |
Adp of the SNF | Dec 1, 2010 | |
| Julie Butenko |
Operational/Managerial Control | Jul 24, 2023 | |
| Adp of the SNF | Jul 24, 2023 | ||
| Crescent Facilities Operations LLC |
5% Or Greater Direct Ownership Interest | Dec 19, 2006 | 100% |
| Heidi Capela |
Operational/Managerial Control | Apr 3, 2023 | |
| Adp of the SNF | Apr 3, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080131000549 | CA | Part a Provider - Skilled Nursing Facility | 4183706922 | Practice locations: Susanville, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 230000058 | CA | Yes |
Addresses
Primary practice location
2005 River Street
Susanville, CA 96130
Mailing address
2005 River Street
Susanville, CA 96130
Phone (530) 257-5341
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZR06231J | Medicaid | CA |
Other names
- Lassen Nursing and Rehabilitation Center
Other providers in Susanville, CA
- Christina Marsa Carlton
- Samuel Richard Carlton
- Carolyn a Matzinger MD a Professional Corporation
- Andrew Timothy Carrion
- Jeanette Lisa Carter
- Terry A Chapman
- Scott Cuong Chau
- Mike Chihwai I
- Rorie Beth Chittock
- Keith Floyd Coker
All providers in Susanville, 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 Feb 9, 2015. 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.