NPIMap

Organization Active NPI

Moragaidence Opco, LLC

  • Skilled Nursing Facility
  • Moraga, CA
National Provider Identifier
1154777357
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MORAGAIDENCE OPCO, LLC
Practice address
348 Rheem Blvd
Moraga, CA 94556-1516
Phone
(925) 376-5995
NPI assigned
May 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

348 Rheem Blvd
Moraga, CA 94556-1516

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Moraga Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161028000576 CA Part A Provider - Skilled Nursing Facility 4082992920 Practice locations: Moraga, CA

Skilled nursing facility certification: CCN 055085

Legal name
MORAGAIDENCE OPCO LLC
Doing business as
MORAGA POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 13, 1970
Last certification
Nov 8, 2024
Beds
49
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jun 1, 2016
Organization structure
LLCProprietary
Incorporated
May 2, 2016 in CA
Enrollment address
348 Rheem Blvd
Moraga, CA 94556-1516
Nursing home name
MORAGA POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Moraga Post AcuteCCN 055085
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 13, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4946.5 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0871027Moraga Post Acute348 Rheem Blvd, Moraga, CA 94556Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2016 100%
Ian a Cook Individual W-2 Managing EmployeeAd; Sep 1, 2022
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Providence Group North LLC Organization, Farmington, UT LLC, For-profit 5% Or Greater Direct Ownership Interest Jun 1, 2016 100%
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%

Facilities with the same owner 80

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

View all 80

Practitioners & affiliated clinicians

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": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1154777357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 RHEEM BLVD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561516",
            "telephone_number": "925-376-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORAGAIDENCE OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moraga Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moraga Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moraga, CA

Sources for this page

Verify at the official NPI Registry.