Ag Rancho Mirage, LLC
Organization Active NPI Skilled Nursing Facility · Rancho Mirage, CA
NPI 1164416657 · NPPES record last updated Jul 21, 2014
Key facts
- NPI
- 1164416657
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 250000245 (CA)
- Legal business name
- AG RANCHO MIRAGE, LLC
- Practice address
- 39950 Vista del Sol
Rancho Mirage, CA 92270 - Phone
- (760) 340-0053
- Fax
- (760) 341-6523
- NPI assigned
- Sep 9, 2005
- Organization subpart
- No
Authorized official
- Name
- Jacob Wintner
- Title
- Manager
- Phone
- (323) 651-1808
Facilities with the same owner 31
Affiliated clinicians 8
-
Clifton Cole, M.D.
-
Sheda Heidarian, M.D.
-
David B Ko, MD
-
Ravinderpal S Mann, M.D.
-
Chahat Thakur, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Rancho Mirage Health and Rehabilitation Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 7, 1987
- Medicare certification status
- Active
- Certified beds
- 99 · 92.8 residents per day on average
- Chain
- Cambridge Healthcare Services
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0572826 | Ag Rancho Mirage | Certificate of waiver | Jun 29, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 555247
- Legal name
- AG RANCHO MIRAGE LLC
- Doing business as
- RANCHO MIRAGE HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 7, 1987
- Last certification
- Feb 6, 2025
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Oct 1, 2003
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 11, 2003 in CA
- Enrollment address
- 39950 Vista del Sol
Rancho Mirage, CA 92270-3206 - Nursing home name
- RANCHO MIRAGE HEALTH AND REHABILITATION CENTER
- Affiliated entity
- CAMBRIDGE HEALTHCARE SERVICES
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| 39950 Vista del Sol, LLC |
Adp of the SNF | May 3, 2004 | |
| Miguel Vidales |
Operational/Managerial Control | Mar 1, 2021 | |
| Managing Control - Governing Body |
Mar 1, 2021 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| BH Alliance |
5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 5% |
| Linda Lutz |
Operational/Managerial Control | Feb 1, 2012 | |
| Adp of the SNF | Feb 1, 2012 | ||
| Ira E Smedra Living Trust |
5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 47.5% |
| Win Win Enterprises, LLC |
5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 47.5% |
| Adp of the SNF | May 3, 2004 | ||
| Lance a Hassell |
Operational/Managerial Control | Apr 25, 2022 | |
| Adp of the SNF | Apr 25, 2022 | ||
| Cambridge Healthcare Services LLC |
Operational/Managerial Control | Oct 1, 2013 | |
| Adp of the SNF | Nov 5, 2025 | ||
| Ira Smedra |
5% Or Greater Indirect Ownership Interest |
Aug 11, 2003 | 47.5% |
| Operational/Managerial Control |
Aug 11, 2003 | ||
| Adp of the SNF | Aug 11, 2003 | ||
| Ag Facilities Operations, LLC |
5% Or Greater Direct Ownership Interest | Aug 11, 2003 | 100% |
| Rafal R Kurzawa |
Operational/Managerial Control | Apr 1, 2025 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Jacob Wintner |
Operational/Managerial Control |
Aug 11, 2003 | |
| Jacob Wintner |
Adp of the SNF | Aug 11, 2003 | |
| Paulina Salazar |
Operational/Managerial Control | Dec 14, 2020 | |
| Adp of the SNF | Dec 14, 2020 | ||
| Julie Butenko |
Operational/Managerial Control | Jul 24, 2023 | |
| Adp of the SNF | Jul 24, 2023 | ||
| Jennifer Caballero |
Operational/Managerial Control | Apr 1, 2025 | |
| Managing Control - Governing Body |
Apr 1, 2025 | ||
| Adp of the SNF | Nov 5, 2025 | ||
| Heidi Capela |
Operational/Managerial Control | Apr 3, 2023 | |
| Adp of the SNF | Apr 3, 2023 | ||
| Glenora Mitchell |
Operational/Managerial Control | Apr 10, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031023000049 | CA | Part a Provider - Skilled Nursing Facility | 5799697462 | Practice locations: Rancho Mirage, CA |
National Provider Directory
Locations
39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 250000245 | CA | Yes |
Addresses
Primary practice location
39950 Vista del Sol
Rancho Mirage, CA 92270
Mailing address
39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC55247G | Medicaid | CA |
Other names
- Rancho Mirage Health & Rehabilitation Center
Other providers in Rancho Mirage, CA
- Advanced Acupuncture & Wellness Center
- Advanced Acupuncture and Healing, Inc.
- Advanced Pain Management
- Advanced Vein Therapeutics
- Mira Afiouni
- Maryan Agamy
- Shahram Aghaei
- Maria Caroline Aguilar
- Francisco Aguirre
- Delshad Ahmad
All providers in Rancho Mirage, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2014. 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.