Fountain View Subacute & Nursing Center, LLC
Organization Active NPI Skilled Nursing Facility · Los Angeles, CA
NPI 1194767871 · NPPES record last updated Jun 5, 2019
Key facts
- NPI
- 1194767871
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 970000008 (CA)
- Legal business name
- FOUNTAIN VIEW SUBACUTE & NURSING CENTER, LLC
- Practice address
- 5310 Fountain Ave
Los Angeles, CA 90029-1005 - Phone
- (323) 461-9961
- Fax
- (323) 461-6854
- NPI assigned
- Jun 10, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SUMMIT CARE LLC
Authorized official
- Name
- Michael T. Berg
- Title
- Assistant Secretary
- Phone
- (505) 468-4752
Owners & managing parties with NPI records 1
-
Jigar Kadakia, M.D.
Facilities with the same owner 211
Affiliated clinicians 4
-
Seung Ho Choi, M.D.
-
Ronald P Lang, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Fountain View Subacute and Nursing Center
- 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
- Active
- Certified beds
- 99 · 85.5 residents per day on average
- Chain
- Genesis Healthcare
- Penalties (3 years)
- 2 · fines totaling $24,531
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0543249 | Fountain View Subacute and Nursing Center, | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
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
All disclosed owners & managing parties 31
| Name | Role | Since | Share |
|---|---|---|---|
| 9560 Pico LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 25% |
| HCCF Management Group XI LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 5.4% |
| Gen Operations I LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 50% |
| Bold Quail Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 100% |
| |
Adp of the SNF | Aug 11, 2025 | |
| Powerback Rehabilitation LLC |
Adp of the SNF | Jun 1, 2020 | |
| Pico Ar LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 25% |
| Jigar Sharad Kadakia |
Operational/Managerial Control | Oct 1, 2022 | |
| Adp of the SNF | Oct 1, 2022 | ||
| Gen Operations II LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 50% |
| BQ Operations Holdings LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2020 | 100% |
| FC-Gen Operations Investment LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 50% |
| Newgen LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 50% |
| Alexis Washington |
Operational/Managerial Control | Oct 6, 2023 | |
| Adp of the SNF | Oct 6, 2023 | ||
| Newgen Administrative Services, LLC |
Adp of the SNF | Jun 1, 2020 | |
| GHC JV Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 50% |
| Arlindo Serumal |
Operational/Managerial Control | Aug 1, 2025 | |
| Adp of the SNF | Aug 1, 2025 | ||
| Sundance Rehabilitation Holdco Inc |
Indirect Ownership Interest | Jun 1, 2020 | 2.6% |
| Avrohom L Tress |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 25% |
| Pamela Shaw |
Operational/Managerial Control | Jun 1, 2020 | |
| Adp of the SNF | Jun 1, 2020 | ||
| Genesis Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 50% |
| Sun Healthcare Group Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 35.25% |
| Gen BQ JV Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 50% |
| |
Adp of the SNF | Aug 11, 2025 | |
| Welltower Op, LLC |
Indirect Ownership Interest | Jun 1, 2020 | 2.7% |
| Arnold M Whitman |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 5.4% |
| Genesis Healthcare Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 50% |
| Zac Properties XI LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 3.8% |
| Steven E Fishman |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 3.8% |
| Aaron H Robin |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 25% |
| GHC Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 50% |
| Genesis Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2020 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031008000032 | CA | Part a Provider - Skilled Nursing Facility | 1052223930 | Practice locations: Los Angeles, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 970000008 | CA | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC70087F | Medicaid | CA | |
| ZZT05111F | Medicaid | CA |
Other names
- Fountain View Subacute and Nursing Center
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All providers in Los Angeles, 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 Jun 5, 2019. 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.