NPIMap

Organization Active NPI

Petunia Holdings, LLC

Doing business as Napa Valley Care Center

  • Skilled Nursing Facility
  • Napa, CA
National Provider Identifier
1225336456
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PETUNIA HOLDINGS, LLC
Doing business as
Napa Valley Care Center
Practice address
3275 Villa LN
Napa, CA 94558-3016
Phone
(707) 257-0931
NPI assigned
Mar 11, 2011
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3275 Villa LN
Napa, CA 94558-3016

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other identifiers 1

IdentifierTypeStateIssuer
1225336456MedicaidCA

Other names 1

  • NAPA VALLEY CARE CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110603000482 CA Part A Provider - Skilled Nursing Facility 4981881703 Practice locations: Napa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225336456. Details of each certification follow.

Skilled nursing facility certification: CCN 555161

Legal name
PETUNIA HOLDINGS, LLC
Doing business as
NAPA VALLEY CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 19, 1984
Last certification
Sep 21, 2021
Beds
130
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS Group Inc.
Organization structure
LLCProprietary
Incorporated
Feb 1, 2011 in CA
Enrollment address
3275 Villa LN
Napa, CA 94558-3016
Nursing home name
NAPA VALLEY CARE CENTER
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Napa Valley Care CenterCCN 555161 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 19, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
130126.3 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $30,259

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
05D0599821Napa Valley Care Center3275 Villa Lane, Napa, CA 94558Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 5, 2021 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Hudson River Opco LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Direct Ownership Interest Nov 5, 2021 100%
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Noel Serrano Individual Contracted Managing EmployeeMD; May 11, 2023
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Spencer L Hadley Individual W-2 Managing EmployeeAdministrator Nov 5, 2021
Operational/Managerial ControlAdministrator Nov 5, 2021
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Bay Bridge Capital Partners, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Nov 5, 2021 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%

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 81

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

View all 81

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1299801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1225336456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 VILLA LN",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583016",
            "telephone_number": "707-257-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETUNIA HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-11",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225336456",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NAPA VALLEY CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NAPA VALLEY CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.