NPIMap

Organization Active NPI

Villa Georgetown Rehabilitation and Healthcare Center LLC

  • Skilled Nursing Facility
  • Georgetown, OH
National Provider Identifier
1255817862
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
VILLA GEORGETOWN REHABILITATION AND HEALTHCARE CENTER LLC
Practice address
8065 Dr Faul Rd
Georgetown, OH 45121-8811
Phone
(732) 372-9636
NPI assigned
Jul 17, 2018
Last updated
Jul 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Authorized official

Name
Moshe Weintraub
Title
Coo
Phone
(732) 372-9636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

8065 Dr Faul Rd
Georgetown, OH 45121-8811

Mailing address

14 Oliver St
Lakewood, NJ 08701-2339

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181120000457 OH Part A Provider - Skilled Nursing Facility 6204180771 Practice locations: Georgetown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255817862. Details of each certification follow.

Skilled nursing facility certification: CCN 365786

Legal name
VILLA GEORGETOWN REHABILITATION AND HEALTHCARE CENTER LLC
Doing business as
VILLA GEORGETOWN REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 6, 1990
Last certification
Jun 27, 2024
Beds
100
Ownership / control type
Corporation
Multi-facility organization
CROWN HEALTHCARE GROUP
Most recent change of ownership
Sep 20, 2018
Organization structure
LLCProprietary
Enrollment address
8065 Dr Faul Rd
Georgetown, OH 45121-8811
Nursing home name
VILLA GEORGETOWN REHABILITATION AND HEALTHCARE CEN
Affiliated entity
CROWN HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Villa Georgetown Rehabilitation and Healthcare CenCCN 365786 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 6, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10076.3 residents per day on average
Chain
Crown Healthcare Group9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Kevin Daubenmire Individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 25%
Operational/Managerial Control Sep 20, 2018
Adp of the SNF Sep 20, 2018
Individual Indirect Ownership Interest Sep 20, 2018 1.14%
Organization, Toms River, NJ LLC Adp of the SNF Dec 16, 2022
Benjamin Shkop Individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 11.25%
Mrs Family Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 20, 2018 14.41%
Adp of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 21.53%
Meir Singer Individual Corporate OfficerPresident Nov 5, 2018
Trustee of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 1.13%
Jeffrey Donohoo Individual Operational/Managerial Control Sep 1, 1985
Adp of the SNF Sep 1, 1985
Organization, Toms River, NJ LLC Adp of the SNF Sep 20, 2018
Crown I TBD Holdco LLC Organization, Toms River, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Oct 9, 2021 100%
Mdatas Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 20, 2018 15.17%
Adp of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 21.53%
Crown Ohio Holdco Inc Organization, Lakewood, NJ LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Sep 20, 2018 100%
Organization, Toms River, NJ LLC Adp of the SNF Dec 1, 2024
Organization, Toms River, NJ LLC Adp of the SNF May 1, 2024
Fejcc Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 20, 2018 14.41%
Trustee of the SNF Sep 20, 2018
Adp of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 21.53%
Capital Finance LLC Organization, Baltimore, MD LLC, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Sep 20, 2018
Adp of the SNF Sep 20, 2018
Organization, Toms River, NJ LLC Adp of the SNF Sep 20, 2018
Gregory Stout Individual Operational/Managerial Control Oct 10, 2020
Adp of the SNF Oct 10, 2020
Individual Trustee of the SNF Sep 20, 2018
Organization, Toms River, NJ LLC Adp of the SNF Jul 25, 2025
Moshe Weintraub Individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 7%
Adp of the SNF Sep 20, 2018

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 14

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

View all 14

Practitioners & affiliated clinicians

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.

Affiliated clinicians 2

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": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1255817862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 OLIVER ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8065 DR FAUL RD",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451218811",
            "telephone_number": "732-372-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA GEORGETOWN REHABILITATION AND HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "WEINTRAUB",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-372-9636"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, OH

Sources for this page

Verify at the official NPI Registry.