NPIMap

Organization Active NPI

Fountain View Subacute & Nursing Center, LLC

Doing business as Fountain View Subacute and Nursing Center

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1194767871
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000008 Issued in CA
Legal business name
FOUNTAIN VIEW SUBACUTE & NURSING CENTER, LLC
Doing business as
Fountain View Subacute and Nursing Center
Practice address
5310 Fountain Ave
Los Angeles, CA 90029-1005
Phone
(323) 461-9961
Fax
(323) 461-6854
NPI assigned
Jun 10, 2006
Last updated
Jun 5, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Authorized official

Name
Michael T. Berg
Title
Assistant Secretary
Phone
(505) 468-4752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 970000008 CA Primary

Addresses

Primary practice location

5310 Fountain Ave
Los Angeles, CA 90029-1005

Mailing address

5310 Fountain Ave
Los Angeles, CA 90029-1005
Phone (323) 461-9961

Other names 1

  • Fountain View Subacute and Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031008000032 CA Part A Provider - Skilled Nursing Facility 1052223930 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194767871. Details of each certification follow.

Skilled nursing facility certification: CCN 055111

Legal name
FOUNTAIN VIEW SUBACUTE & NURSING CENTER, LLC
Doing business as
FOUNTAIN VIEW SUBACUTE AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1971
Last certification
May 8, 2025
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
LLC
Enrollment address
5310 Fountain Ave
Los Angeles, CA 90029-1005
Nursing home name
FOUNTAIN VIEW SUBACUTE AND NURSING CENTER
Affiliated entity
GENESIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fountain View Subacute and Nursing CenterCCN 055111 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9985.5 residents per day on average
Chain
Genesis Healthcare184 facilities in the chain
Penalties (3 years)
2Fines totaling $24,531

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
05D0543249Fountain View Subacute and Nursing Center,5310 Fountain Ave, Los Angeles, CA 90029Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

5310 Fountain Ave
Los Angeles, CA 90029
Phone (323) 461-9961

Ownership & related parties

All disclosed owners & managing parties 31

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

NameRoleSinceShare
9560 Pico LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 25%
HCCF Management Group XI LLC Organization, Alpharetta, GA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 5.4%
Gen Operations I LLC Organization, Kennett Square, PA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 50%
Bold Quail Holdings LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 100%
Individual Adp of the SNF Aug 11, 2025
Powerback Rehabilitation LLC Organization, Kennett Square, PA LLC Adp of the SNF Jun 1, 2020
Pico Ar LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 25%
Jigar Sharad Kadakia Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Gen Operations II LLC Organization, Kennett Square, PA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 50%
BQ Operations Holdings LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2020 100%
FC-Gen Operations Investment LLC Organization, Kennett Square, PA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 50%
Newgen LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 50%
Alexis Washington Individual Operational/Managerial Control Oct 6, 2023
Adp of the SNF Oct 6, 2023
Newgen Administrative Services, LLC Organization, Los Angeles, CA LLC Adp of the SNF Jun 1, 2020
GHC JV Holdings LLC Organization, Kennett Square, PA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 50%
Arlindo Serumal Individual Operational/Managerial Control Aug 1, 2025
Adp of the SNF Aug 1, 2025
Sundance Rehabilitation Holdco Inc Organization, Kennett Square, PA Corporation, Holding company, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2020 2.6%
Avrohom L Tress Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 25%
Pamela Shaw Individual Operational/Managerial Control Jun 1, 2020
Adp of the SNF Jun 1, 2020
Genesis Healthcare LLC Organization, Kennett Square, PA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 50%
Sun Healthcare Group Inc Organization, Kennett Square, PA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 35.25%
Gen BQ JV Holdings LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 50%
Individual Adp of the SNF Aug 11, 2025
Welltower Op, LLC Organization, Toledo, OH LLC, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2020 2.7%
Arnold M Whitman Individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 5.4%
Genesis Healthcare Inc Organization, Kennett Square, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 50%
Zac Properties XI LLC Organization, Philadelphia, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 3.8%
Steven E Fishman Individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 3.8%
Aaron H Robin Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 25%
GHC Holdings LLC Organization, Kennett Square, PA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 50%
Genesis Holdings LLC Organization, Kennett Square, PA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 50%

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 211

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

View all 211

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1194767871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291005",
            "telephone_number": "323-461-9961",
            "fax_number": "323-461-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291005",
            "telephone_number": "323-461-9961",
            "fax_number": "323-461-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN VIEW SUBACUTE & NURSING CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT CARE LLC",
        "enumeration_date": "2006-06-10",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain View Subacute and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fountain View Subacute and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.