Indian Lake Healthcare Group, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

INDIAN LAKE HEALTHCARE GROUP, LLC

Doing business as

Indian Lake Rehabilitation Center

Practice address

14442 US Highway 33
Lakeview, OH 43331-9284

Phone

(937) 843-4929

Fax

(937) 843-3936

NPI assigned

Nov 29, 2016

Last updated

Jan 14, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SABER HEALTHCARE HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

William I Weisberg

Title

President

Phone

(216) 292-5706

Specialties & licenses 1

Addresses

Other names 1

• Indian Lake Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124561873. Details of each certification follow.

• CCN 365666 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 365666

Legal name

INDIAN LAKE HEALTHCARE GROUP LLC

Doing business as

INDIAN LAKE REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 16, 1985

Last certification

Jun 20, 2024

Beds

40

Ownership / control type

Corporation

Multi-facility organization

SABER HEALTHCARE GROUP

Most recent change of ownership

Dec 1, 2016

Organization structure

LLCProprietary

Enrollment address

14442 US Highway 33
Lakeview, OH 43331-9284

Nursing home name

INDIAN LAKE REHABILITATION CENTER

Affiliated entity

SABER HEALTHCARE GROUP

Listed as

Indian Lake Rehabilitation CenterCCN 365666 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 16, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4035.6 residents per day on average

Chain

Saber Healthcare Group126 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Health Care and Retirement Corporation of America2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Heartland-Indian Lake of Lakeview Oh LLC

  dba Heartland of Indian Lake Rehabilitation Center

  • Skilled Nursing Facility
  • Lakeview, OH
  • NPI 1154363794
  NPD tax ID

Locations

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.

Owners & managing parties with NPI records 1

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

• Gregg S Fulmer, MD

  • Hospitalist Physician
  • Bellefontaine, OH
  • NPI 1396781944

  Adp of the SNF

  CMS ownership

Facilities with the same owner 122

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

• Astoria Healthcare Group, LLC

  dba Astoria Health & Rehab Center

  • Skilled Nursing Facility
  • Germantown, OH
  • NPI 1346513090

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Bath Creek Healthcare Group, Inc.

  • Skilled Nursing Facility
  • Cuyahoga Falls, OH
  • NPI 1568716652

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Bellevue Healthcare Group, LLC

  • Skilled Nursing Facility
  • Bellevue, OH
  • NPI 1730488685

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Brecksville Healthcare Group, Inc.

  dba Oaks of Brecksville

  • Skilled Nursing Facility
  • Brecksville, OH
  • NPI 1043518038

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Centerburg Pointe Healthcare Group, Inc.

  • Skilled Nursing Facility
  • Centerburg, OH
  • NPI 1033410295

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Cortland Healthcare Group Inc.

  dba Cortland Nursing Home

  • Skilled Nursing Facility
  • Cortland, OH
  • NPI 1871641936

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, Wiw Dynasty LLC

  CMS ownership
• Dayton Health & Rehab Center, LLC

  dba Carillon Health & Rehab Center

  • Skilled Nursing Facility
  • Dayton, OH
  • NPI 1720478472

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Diplomate Healthcare LLC

  • Skilled Nursing Facility
  • North Royalton, OH
  • NPI 1124206735

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Eagle Creek Healthcare Group, Inc.

  dba Eagle Creek Nursing Center

  • Skilled Nursing Facility
  • West Union, OH
  • NPI 1558392100

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Grand Rapids Healthcare Group, LLC

  • Skilled Nursing Facility
  • Grand Rapids, OH
  • NPI 1174822886

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• High Pointe Health & Rehab Center, LLC

  dba Highland Pointe Health & Rehabilitation Center

  • Skilled Nursing Facility
  • Highland Heights, OH
  • NPI 1073996658

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership
• Homestead I Healthcare Group, LLC

  dba Grand River Health & Rehab Center

  • Skilled Nursing Facility
  • Painesville, OH
  • NPI 1710245774

  Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020), BNV Dynasty LLC, Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020, Saber Governance LLC, Saber Healthcare Holdings LLC, SHG Management LLC, Wiw Dynasty LLC

  CMS ownership

Practitioners 1

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.

• Gregg S Fulmer, MD

  • Hospitalist Physician
  • Bellefontaine, OH
  • NPI 1396781944
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Gregg S Fulmer, MD

  • Hospitalist Physician
  • Bellefontaine, OH
  • NPI 1396781944

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1124561873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23700 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225827",
            "telephone_number": "216-292-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14442 US HIGHWAY 33",
            "city": "LAKEVIEW",
            "state": "OH",
            "postal_code": "433319284",
            "telephone_number": "937-843-4929",
            "fax_number": "937-843-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN LAKE HEALTHCARE GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SABER HEALTHCARE HOLDINGS, LLC",
        "enumeration_date": "2016-11-29",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-292-5706"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Lake Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indian Lake Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald Aarin Hollar
• Leslie Ann Hollar
• Sally Jane Houser, LPN
• Indian Lake Chiropractic Centre Inc.
• Indian Lake EMS Joint Ambulance District
• Kristy Jo Jakeway, FNP-C
• Loretta Annette Kinney
• Tamara Kae Martin
• Talea Paige McGinnis
• New Path Clinical Services LLC

• Skilled Nursing Facility in Lakeview, OH
• Providers in Lakeview, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.

Verify at the official NPI Registry.