San Juan Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAN JUAN CARE CENTER LLC

Doing business as

San Juan Care Center

Practice address

806 W Maple St
Farmington, NM 87401-5631

Phone

(505) 325-2910

Fax

(505) 325-0191

NPI assigned

Jun 9, 2023

Last updated

Jun 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Garetz

Title

Cfo

Phone

(323) 987-5954

Specialties & licenses 1

Addresses

Other names 1

• San Juan Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124702246. Details of each certification follow.

• CCN 325085 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 325085

Legal name

SAN JUAN CARE CENTER LLC

Doing business as

SAN JUAN CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1992

Last certification

Feb 29, 2024

Beds

93

Ownership / control type

Corporation

Organization structure

LLCProprietary

Enrollment address

806 W Maple St
Farmington, NM 87401-5631

Nursing home name

SAN JUAN CARE CENTER

Affiliated entity

OPCO SKILLED MANAGEMENT

Listed as

San Juan Care CenterCCN 325085 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Dec 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9389.8 residents per day on average

Chain

Opco Skilled Management66 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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.

• Stephen W Shanks, DO

  • Family Medicine Physician
  • Shiprock, NM
  • NPI 1114346129

  Adp of the SNF

  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.

• Stephen W Shanks, DO

  • Family Medicine Physician
  • Shiprock, NM
  • NPI 1114346129
  NPD (past)

Affiliated clinicians 1

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

• Stephen W Shanks, DO

  • Family Medicine Physician
  • Shiprock, NM
  • NPI 1114346129

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1124702246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-325-2910",
            "fax_number": "505-325-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-325-2910",
            "fax_number": "505-325-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "GARETZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "323-987-5954"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juan Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Morris Saltzman, MD
• Sam's Club Optical (Sam's Club Optical 30-6357)
• Shauna M Samora, LMSW
• Sams East Inc (Sams Pharmacy 10-6347)
• Samuel C. Carpenter, Dpmpc
• San Juan Center for Independence
• San Juan College
• San Juan College
• San Juan College
• San Juan College Family Resource Center

• Skilled Nursing Facility in Farmington, NM
• Providers in Farmington, NM by specialty
• Skilled Nursing Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.