Clarksville Health & Rehab Center, LLC
Organization Active NPI Skilled Nursing Facility · Clarksville, VA
NPI 1134738248 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1134738248
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- CLARKSVILLE HEALTH & REHAB CENTER, LLC
- Practice address
- 184 Buffalo Rd
Clarksville, VA 23927-9010 - Phone
- (434) 374-4141
- NPI assigned
- Jul 24, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- SABER HEALTHCARE HOLDINGS, LLC
Authorized official
- Name
- William I. Weisberg
- Title
- President
- Phone
- (216) 292-5706
Owners & managing parties with NPI records 1
-
Mazen I Madhoun, MD
Facilities with the same owner 115
Affiliated clinicians 1
-
Craig P Prokos, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Clarksville Health & Rehab Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 1, 2004
- Medicare certification status
- Active
- Certified beds
- 168 · 143.6 residents per day on average
- Chain
- Saber Healthcare Group
- Penalties (3 years)
- 1 · fines totaling $22,874
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0982100 | Clarksville Health & Rehab Center | Certificate of waiver | Jan 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Skilled nursing facility certification: CCN 495379
- Legal name
- CLARKSVILLE HEALTH & REHAB CENTER LLC
- Doing business as
- CLARKSVILLE HEALTH & REHAB CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 2004
- Last certification
- Nov 30, 2022
- Beds
- 168
- Ownership / control type
- Corporation
- Multi-facility organization
- Saber Healthcare Group
- Most recent change of ownership
- Nov 1, 2020
- Organization structure
- LLC · Proprietary
- Enrollment address
- 184 Buffalo Rd
Clarksville, VA 23927-9010 - Nursing home name
- CLARKSVILLE HEALTH & REHAB CENTER
- Affiliated entity
- SABER HEALTHCARE GROUP
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Saber Healthcare Holdings LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2020 | 100% |
| WWBV Holdings LLC |
5% Or Greater Indirect Ownership Interest | Nov 1, 2020 | 100% |
| SHG Boa LLC |
Adp of the SNF | Feb 26, 2026 | |
| Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020) |
5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 22.22% |
| Alexis N Farmer |
Operational/Managerial Control | May 31, 2024 | |
| Adp of the SNF | May 31, 2024 | ||
| Ohi Asset (VA) Clarksville LLC |
5% Or Greater Security Interest | Nov 1, 2020 | 100% |
| Adp of the SNF | Nov 1, 2020 | ||
| Gregory Nicoluzakis |
Corporate Officer |
Nov 1, 2020 | |
| Adp of the SNF | Nov 1, 2020 | ||
| SHG Management LLC |
Adp of the SNF | Nov 1, 2020 | |
| Saber Governance LLC |
Adp of the SNF | Nov 1, 2020 | |
| BNV Dynasty LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2023 | 33% |
| Benjamin N Volpe |
Corporate Officer |
Nov 1, 2020 | |
| Corporate Director |
Nov 1, 2020 | ||
| Adp of the SNF | Nov 1, 2020 | ||
| Mazen I Madhoun |
Adp of the SNF | Jan 20, 2025 | |
| Citrin Cooperman Advisors LLC |
Adp of the SNF | Nov 1, 2020 | |
| Wiw Dynasty LLC |
5% Or Greater Indirect Ownership Interest | Nov 1, 2020 | 77.78% |
| TCF National Bank |
Adp of the SNF | Dec 2, 2022 | |
| William I Weisberg |
Corporate Officer |
Nov 1, 2020 | |
| Corporate Director |
Nov 1, 2020 | ||
| Adp of the SNF | Nov 1, 2020 | ||
| Walker & Associates PC |
Adp of the SNF | Nov 1, 2020 | |
| Joseph C Hopkins |
Operational/Managerial Control | May 8, 2023 | |
| Adp of the SNF | May 8, 2023 | ||
| SHH Holdings LLC |
5% Or Greater Indirect Ownership Interest | Nov 1, 2020 | 100% |
| Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020 |
5% Or Greater Indirect Ownership Interest | Jan 1, 2023 | 67% |
| SHG Mt, LLC |
Adp of the SNF | Feb 26, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201231001720 | VA | Part a Provider - Skilled Nursing Facility | 1456764844 | Practice locations: Clarksville, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
184 Buffalo Rd
Clarksville, VA 23927-9010
Mailing address
23700 Commerce Park
Beachwood, OH 44122-5827
Phone (216) 292-5706
Other providers in Clarksville, VA
- Beverly Y. Chestnutt
- Marah Christine Clarkson
- Clarksville Chiropractic Center PC
- Clarksville Community Pharmacy, Inc.
- Clarksville Counseling Center, PLC
- Clarksville Senior Care, LLC
- Clarksville Senior Care, LLC
- Allyson Michelle Collins
- Brianna Collins
- Ashley Combs
All providers in Clarksville, VA · Skilled Nursing Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. 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.