Organization Active NPI

Avalon Care Center - Aberdeen, LLC

Doing business as Grays Harbor Health & Rehabilitation Center

  • Skilled Nursing Facility
  • Aberdeen, WA
National Provider Identifier
1194719450
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1356 Issued in WA
Legal business name
AVALON CARE CENTER - ABERDEEN, LLC
Doing business as
Grays Harbor Health & Rehabilitation Center
Practice address
920 Anderson Dr
Aberdeen, WA 98520-1007
Phone
(360) 532-5122
Fax
(360) 532-9048
NPI assigned
Sep 1, 2005
Last updated
Nov 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Charles Kirton
Title
Ceo/Chairman
Phone
(801) 596-8844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1356 WA Primary

Addresses

Primary practice location

920 Anderson Dr
Aberdeen, WA 98520-1007

Mailing address

206 N 2100 W
Salt Lake City, UT 84116-2927
Phone (801) 325-0153

Other identifiers 1

IdentifierTypeStateIssuer
4113569MedicaidWA

Other names 1

  • Grays Harbor Health & Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030920000008 WA Part A Provider - Skilled Nursing Facility 4688585763 Practice locations: Aberdeen, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194719450. Details of each certification follow.

Skilled nursing facility certification: CCN 505016

Legal name
AVALON CARE CENTER - ABERDEEN, LLC
Doing business as
GRAYS HARBOR HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Mar 19, 2025
Beds
105
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Avalon Healthcare
Organization structure
LLCProprietary
Incorporated
Aug 26, 2003 in WA
Enrollment address
920 Anderson Dr
Aberdeen, WA 98520-1007
Nursing home name
GRAYS HARBOR HEALTH & REHABILITATION CENTER
Affiliated entity
AVALON HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grays Harbor Health & Rehabilitation CenterCCN 505016 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10567.4 residents per day on average
Chain
Avalon Health Care16 facilities in the chain

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
50D0673874Grays Harbor Health & Rehabilitation Center920 Anderson Drive, Aberdeen, WA 98520Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Neel Ramesh Chheda Individual Operational/Managerial Control Jun 1, 2023
Adp of the SNF Jun 1, 2023
The Byron a Kirton Individual TR Organization, Alpine, UT 5% Or Greater Indirect Ownership Interest Oct 1, 2025 26.67%
Robert D Woltil Individual Corporate DirectorBoard Director May 23, 2012
Managing Control - Governing BodyBoard Director May 23, 2012
Avalon Health Care Management Inc Organization, Salt Lake City, UT Corporation, Management services company, For-profit Operational/Managerial Control Dec 1, 2003
Adp of the SNF Apr 7, 2025
Avalon Holdco Equities, L.L.C. Organization, Salt Lake City, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 15, 2026 100%
920 Anderson Drive, L.L.C. Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Nov 30, 2024
Hyrum a Kirton Individual TR Organization, Sandy, UT 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Spencer Kirton Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Corporate DirectorBoard Director Aug 27, 2024
Managing Control - Governing BodyBoard Director Aug 27, 2024
Chukwuemeka Nwankwo Individual Operational/Managerial Control Apr 14, 2026
Adp of the SNF Apr 14, 2026
Nicole Smith Individual Corporate OfficerChief Nursing Officer Mar 1, 2023
Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Avalon Health Care Inc Organization, Salt Lake City, UT Corporation, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 26, 2003 100%
Operational/Managerial Control Dec 1, 2003
Adp of the SNF Dec 1, 2003
Bradford Harris Individual Corporate OfficerCfo Mar 16, 2026
Operational/Managerial Control Mar 16, 2026
Adp of the SNF Mar 16, 2026
Byron a Kirton Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Corporate DirectorBoard Director Aug 27, 2024
Managing Control - Governing BodyBoard Director Aug 27, 2024
Avalon of Washington LLC Organization, Salt Lake City, UT LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 20, 2004 100%
K-Team LLC Organization, Alpine, UT LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2025 6.67%
Avalon Care LLC Organization, Salt Lake City, UT LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 26, 2003 100%
Hyrum Kirton Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Corporate OfficerSenior Vice President Mar 29, 2022
Corporate DirectorBoard Director Aug 27, 2024
Operational/Managerial Control Mar 29, 2022
Managing Control - Governing BodyBoard Director Aug 27, 2024
Adp of the SNF Mar 29, 2022
Spencer K Kirton Individual TR Organization, Coalville, UT 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
David E Dangerfield Individual Corporate DirectorBoard Director Apr 5, 2007
Managing Control - Governing BodyBoard Director Apr 5, 2007
Avalon Holding Inc Organization, Salt Lake City, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2003 100%
Keli Clevenger Individual Operational/Managerial Control Mar 12, 2023
Adp of the SNF Mar 12, 2023
Alan B Hash Individual Corporate OfficerCeo Aug 15, 2017
Operational/Managerial Control Aug 15, 2017
Adp of the SNF Aug 15, 2017

Owners & managing parties with NPI records 1

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

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 3

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": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1194719450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841162927",
            "telephone_number": "801-325-0153",
            "fax_number": "801-596-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 ANDERSON DR",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201007",
            "telephone_number": "360-532-5122",
            "fax_number": "360-532-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CARE CENTER - ABERDEEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "KIRTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO/CHAIRMAN",
        "authorized_official_telephone_number": "801-596-8844"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113569",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grays Harbor Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.