Kingman No 1 LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI306 Issued in AZ

Legal business name

KINGMAN NO 1 LLC

Doing business as

Desert Highlands Care Center

Practice address

1081 Kathleen Ave
Kingman, AZ 86401-3918

Phone

(928) 753-5580

NPI assigned

Jul 7, 2006

Last updated

Jan 3, 2017By 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

Cliff Shirrell

Title

Vice President

Phone

(573) 471-1276

Specialties & licenses 1

Addresses

Other names 1

• Desert Highlands Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184656175. Details of each certification follow.

• CCN 035169 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 035169

Legal name

KINGMAN NO 1 LLC

Doing business as

DESERT HIGHLANDS CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 23, 1988

Last certification

Mar 14, 2025

Beds

120

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Avant Guard

Organization structure

LLCProprietary

Enrollment address

1081 Kathleen Ave
Kingman, AZ 86401-3918

Nursing home name

DESERT HIGHLANDS CARE CENTER

Affiliated entity

CIRCLE B ENTERPRISES

Listed as

Desert Highlands Care CenterCCN 035169 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

May 23, 1988

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12074.5 residents per day on average

Chain

Circle B Enterprises36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Interoperability endpoints

• Direct secure messaging: daniel.itano@mmdeserthighlandcc.contexture.medalliesmail.com

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 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Daniel Itano, D.O.

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1194133041

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Sovereign Healthcare Group, LLC

  • Home Health Agency
  • New Madrid, MO
  • NPI 1447821418

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 41

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

• Havasu Nursing Center 2 Inc

  dba Havasu Nursing Center

  • Skilled Nursing Facility
  • Lake Havasu City, AZ
  • NPI 1831121813

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Sandretto Hills Nursing Center 2

  dba Mountain View Manor

  • Skilled Nursing Facility
  • Prescott, AZ
  • NPI 1235161233

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Yuma Nursing Center 2 Inc

  dba Yuma Nursing Center

  • Skilled Nursing Facility
  • Yuma, AZ
  • NPI 1629006663

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Ava No 1 Inc

  • Skilled Nursing Facility
  • Ava, MO
  • NPI 1518999515

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Boonville No 1 Inc

  dba Lakeview Health Care & Rehabilitation Center

  • Skilled Nursing Facility
  • Boonville, MO
  • NPI 1295767275

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Boonville No2 Inc

  dba Riverdell Care Center

  • Skilled Nursing Facility
  • Boonville, MO
  • NPI 1740212760

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Cameron No 1 Inc

  dba Quail Run Health Care Center

  • Skilled Nursing Facility
  • Cameron, MO
  • NPI 1194757112

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Cape Girardeau I Inc

  dba Heartland Care & Rehabilitation Center

  • Skilled Nursing Facility
  • Cape Girardeau, MO
  • NPI 1649202623

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Caruthersville No 1 Inc

  dba Southgate Living Center

  • Skilled Nursing Facility
  • Caruthersville, MO
  • NPI 1457708018

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Clinton No 1 Inc

  • Skilled Nursing Facility
  • Clinton, MO
  • NPI 1033141015

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Clinton No 2 Inc

  dba Adair Village

  • Skilled Nursing Facility
  • Clinton, MO
  • NPI 1548913288

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Collins Acres Care Center Inc

  dba Sikeston Convalescent Center

  • Skilled Nursing Facility
  • Sikeston, MO
  • NPI 1912939976

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership

Practitioners 3

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.

• Daniel Itano, D.O.

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1194133041
  NPD
• Thomas F. Garland, M.D.

  • Family Medicine Physician
  • Prescott Valley, AZ
  • NPI 1700837853
  NPD (past)
• John A Weidner, D.O.

  • Family Medicine Physician
  • Kingman, AZ
  • NPI 1467438143
  NPD (past)

Affiliated clinicians 2

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

• Daniel Itano, D.O.

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1194133041

  Nursing home

  Care Compare affiliation
• John A Weidner, D.O.

  • Family Medicine Physician
  • Kingman, AZ
  • NPI 1467438143

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1184656175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 KATHLEEN AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864013918",
            "telephone_number": "928-753-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGMAN NO 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "SHIRRELL",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Highlands Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kingman Healthcare, Inc (KRMC Community Pharmacy)
• Kingman Hometown Pharmacy LLC (Kingman Hometown Pharmacy)
• Kingman Hospital Inc
• Kingman Kidney Clinic Inc.
• Kingman Neurology
• Kingman Oncology Institute LLC
• Kingman Pulmonary Associates, LLC
• Kingman Radiology Associates LLC
• Kingman Senior Living, LLC (White Cliffs Senior Living)
• Kingman Transportation Service, LLC (Kingman Cab Company)

• Skilled Nursing Facility in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.