Active NPI
Maclay Healthcare LLC
Doing business as Maclay Healthcare Center
- Skilled Nursing Facility
- Sylmar, CA
National Provider Identifier
1184097719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MACLAY HEALTHCARE LLC
- Doing business as
- Maclay Healthcare Center
- Practice address
- 12831 Maclay St
Sylmar, CA 91342-4934 - Phone
- (818) 361-4455
- Fax
- (818) 837-9369
- NPI assigned
- Nov 4, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chaim Moshe Raskin
- Title
- Authorized Official
- Phone
- (818) 309-2454
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | CA | Primary |
Addresses
Primary practice location
12831 Maclay St
Sylmar, CA 91342-4934
Mailing address
1267 Willis St Ste 200
Redding, CA 96001-0400
Phone (818) 309-2454
Other names 1
- Maclay Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160129001937 | CA | Part A Provider - Skilled Nursing Facility | 0547563215 | Practice locations: Sylmar, CA |
Skilled nursing facility certification: CCN 555583
- Legal name
- MACLAY HEALTHCARE LLC
- Doing business as
- MACLAY HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 1993
- Last certification
- Oct 11, 2024
- Beds
- 141
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Oct 13, 2015 in CA
- Enrollment address
- 12831 Maclay St
Sylmar, CA 91342-4934 - Nursing home name
- MACLAY HEALTHCARE CENTER
- Affiliated entity
- SERRANO GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Maclay Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 1, 1993
- Medicare certification status
- Active
- Certified beds
- 141
- Chain
- Serrano Group
- Special focus status
- SFF Candidate
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 12
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lory Lynn LLC | 5% Or Greater Direct Ownership Interest | Nov 1, 2015 | 16.5% |
| Maclay Partners LLC | 5% Or Greater Direct Ownership Interest | Nov 1, 2015 | 16.5% |
| Dov E Jacobs | 5% Or Greater Direct Ownership Interest | Nov 1, 2015 | 19.5% |
| Corporate Officer | Nov 1, 2015 | 100% | |
| Benjamin Landa | 5% Or Greater Direct Ownership Interest | Nov 1, 2015 | 47.5% |
| Corporate Officer | Nov 1, 2015 | 100% | |
| Judah Taub | 5% Or Greater Indirect Ownership Interest | Nov 1, 2015 | 16.5% |
| Howard Fensterman | 5% Or Greater Indirect Ownership Interest | Nov 1, 2015 | 16.5% |
| Mark J Donohoe | Operational/Managerial Control | Nov 1, 2015 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Bakersfield, CA
- NPI 1649616855
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1604016000000",
"number": "1184097719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1267 WILLIS ST STE 200",
"city": "REDDING",
"state": "CA",
"postal_code": "960010400",
"telephone_number": "818-309-2454",
"fax_number": "818-837-9369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12831 MACLAY ST",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913424934",
"telephone_number": "818-361-4455",
"fax_number": "818-837-9369"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MACLAY HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-11-04",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A",
"authorized_official_last_name": "RASKIN",
"authorized_official_first_name": "CHAIM",
"authorized_official_middle_name": "MOSHE",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "818-309-2454"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Maclay Healthcare Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Maclay Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.