NPIMap

Organization Active NPI

Santa Rosa SNF Operations LLC

  • Skilled Nursing Facility
  • Milton, FL
National Provider Identifier
1255977534
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SANTA ROSA SNF OPERATIONS LLC
Practice address
5386 Broad St
Milton, FL 32570-2235
Phone
(850) 623-4661
Fax
(850) 623-6039
NPI assigned
Nov 21, 2019
Last updated
Jan 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Solomon Klein
Title
Manager
Phone
(347) 909-1811

Specialties & licenses 1

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

Addresses

Primary practice location

5386 Broad St
Milton, FL 32570-2235

Mailing address

2123 Centre Pointe Blvd
Tallahassee, FL 32308-4930
Phone (850) 386-2831

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200113000983 FL Part A Provider - Skilled Nursing Facility 7012342496 Practice locations: Milton, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255977534. Details of each certification follow.

Skilled nursing facility certification: CCN 105328

Legal name
SANTA ROSA SNF OPERATIONS LLC
Doing business as
SANTA ROSA CENTER FOR REHABILITATION AND HEALING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1978
Last certification
Aug 1, 2024
Beds
110
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Sep 23, 2019 in FL
Enrollment address
5386 Broad St
Milton, FL 32570-2235
Nursing home name
SANTA ROSA CENTER FOR REHABILITATION AND HEALING
Affiliated entity
SUMMIT CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Santa Rosa Center for Rehabilitation and HealingCCN 105328 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11098.2 residents per day on average
Chain
Summit Care22 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
10D0880892Santa Rosa SNF Operations LLC5386 Broad St, Milton, FL 32570Certificate of waiverDec 27, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Solomon Klein Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 25%
Operational/Managerial Control Feb 1, 2020 100%
Summit Care II Inc Organization, Tallahassee, FL Corporation Operational/Managerial Control Feb 1, 2020 100%
Ezriel Drebin Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 8%
Santa Rosa SNF Operations Holdings LLC Organization, Lakewood, NJ Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Feb 1, 2020 100%
Shaul Kopelowitz Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 10%
Yisroel E Herzka Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 41.25%
Aaron Mayer Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 10%

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

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": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1255977534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 CENTRE POINTE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084930",
            "telephone_number": "850-386-2831",
            "fax_number": "850-386-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5386 BROAD ST",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325702235",
            "telephone_number": "850-623-4661",
            "fax_number": "850-623-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-909-1811"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

Verify at the official NPI Registry.