NPIMap

Organization Active NPI

Prime Healthcare Services - Saint Clare'S LLC

  • Skilled Nursing Facility
  • Dover, NJ
National Provider Identifier
1124407903
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC
Practice address
400 W Blackwell St
Dover, NJ 07801-2525
Phone
(973) 989-3000
NPI assigned
May 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Michael Heather
Title
Chief Financial Officer
Phone
(909) 235-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

400 W Blackwell St
Dover, NJ 07801-2525

Mailing address

3300 E Guasti Rd
Third Floor
Ontario, CA 91761-8655
Phone (909) 235-4300

Other names 1

  • The Dwelling Place at Saint Clare's Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151211000750 NJ Part A Provider - Skilled Nursing Facility 6406165372 Practice locations: Dover, NJ

Skilled nursing facility certification: CCN 315019

Legal name
PRIME HEALTHCARE SERVICES - SAINT CLARE'S, LLC
Doing business as
THE DWELLING PLACE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Nov 27, 2023
Beds
28
Ownership / control type
Corporation
Multi-facility organization
Prime Healthcare
Organization structure
LLCProprietary
Incorporated
Jun 26, 2013 in DE
Enrollment address
400 West Blackwell Street
Dover, NJ 07801-2525
Nursing home name
DWELLING PLACE AT ST CLARES
Affiliated entity
PRIME HEALTHCARE

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Dwelling Place at St ClaresCCN 315019
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2827.2 residents per day on average
Chain
Prime Healthcare6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services - Saint Clare'S LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation, For-profit 5% Or Greater Direct Ownership Interest Jun 26, 2013 100%
Other Oct 1, 2015 100%
Troy a Schell Individual Corporate OfficerSecretary/General Counsel Jun 26, 2013
Michael a Heather Individual Corporate OfficerCfo Jun 26, 2013
Operational/Managerial ControlCfo Oct 1, 2015
Luis Leon Individual Corporate OfficerPresident/Hospital Operations II Jun 26, 2013
Operational/Managerial ControlPresident/Hospital Operations II Oct 1, 2015
Thomas G Scott Individual Corporate OfficerHospital/Cfo Oct 1, 2015
W-2 Managing EmployeeHospital/Cfo Oct 1, 2015
MPT of Morris LLC Organization, Birmingham, AL LLC, Investment firm 5% Or Greater Mortgage Interest Oct 1, 2015 100%
5% Or Greater Security Interest Oct 1, 2015 100%
Christopher Doan Individual Corporate OfficerChief Compliane Counsel Jul 1, 2017
Kasp Trusts Organization, Victorville, CA For-profit 5% Or Greater Indirect Ownership Interest Jun 26, 2013 100%
Prem Reddy Individual Corporate OfficerPresident/Ceo Jun 26, 2013
Operational/Managerial ControlPresident/Ceo Oct 1, 2015
Bryan D Burklow Individual Corporate OfficerHospital Interm Ceo Jun 26, 2013
W-2 Managing EmployeeHospital Interm Ceo Oct 1, 2015
Prime Healthcare Holdings Inc Organization, Ontario, CA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 26, 2013 100%

Facilities with the same owner 77

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

View all 77

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1124407903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E GUASTI RD",
            "address_2": "THIRD FLOOR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618655",
            "telephone_number": "909-235-4300",
            "fax_number": "909-235-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078012525",
            "telephone_number": "973-989-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "HEATHER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "909-235-4300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dwelling Place at Saint Clare's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, NJ

Sources for this page

Verify at the official NPI Registry.