Guava Holdings LLC
Organization Active NPI Skilled Nursing Facility · Yuba City, CA
NPI 1275923773 · NPPES record last updated Aug 20, 2024
Key facts
- NPI
- 1275923773
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 230000129 (CA)
- Legal business name
- GUAVA HOLDINGS LLC
- Practice address
- 1220 Plumas St
Yuba City, CA 95991-3411 - Phone
- (530) 671-0550
- NPI assigned
- Feb 4, 2015
- Organization subpart
- No
Authorized official
- Name
- John Mitchell
- Title
- Secretary
- Phone
- (385) 988-3319
Owners & managing parties with NPI records 1
Facilities with the same owner 81
Affiliated clinicians 3
-
Dung M Tran, MD
-
Zahid Nadeem, MD
Medicare Care Compare: Nursing home
- Listed as
- Yuba City Post Acute
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 1, 1968
- Medicare certification status
- Active
- Certified beds
- 59 · 54.5 residents per day on average
- Chain
- Pacs Group
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0874396 | Guava Holdings Dba Yuba City Post-Acute | Certificate of waiver | Jul 13, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 055092
- Legal name
- GUAVA HOLDINGS LLC
- Doing business as
- YUBA CITY POST-ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 1968
- Last certification
- Aug 30, 2024
- Beds
- 59
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 8, 2015 in DE
- Enrollment address
- 1220 Plumas St
Yuba City, CA 95991-3411 - Nursing home name
- YUBA CITY POST ACUTE
- Affiliated entity
- PACS GROUP
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Providence Group Inc |
5% Or Greater Indirect Ownership Interest | Nov 5, 2021 | 100% |
| Jason H Murray |
5% Or Greater Indirect Ownership Interest | Apr 15, 2024 | 41.8% |
| John T Mitchell |
Corporate Officer |
Jan 1, 2024 | |
| Shailaja Vemulapalli |
Contracted Managing Employee |
Aug 9, 2022 | |
| Jorin Larsen |
W-2 Managing Employee |
Apr 3, 2023 | |
| Hudson River Opco LLC |
5% Or Greater Direct Ownership Interest | Oct 1, 2019 | 100% |
| Frederick G Apt |
Corporate Officer |
Jan 1, 2024 | |
| Pacs Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Joshua O Jergensen |
Corporate Officer |
Jan 1, 2024 | |
| Pacs Group, Inc. |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Bay Bridge Capital Partners, LLC |
5% Or Greater Indirect Ownership Interest | Dec 16, 2015 | 100% |
| Mark D Hancock |
5% Or Greater Indirect Ownership Interest | Apr 15, 2024 | 41.8% |
| Corporate Officer |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150810000440 | CA | Part a Provider - Skilled Nursing Facility | 2567776230 | Practice locations: Yuba City, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 230000129 | CA | Yes |
Addresses
Primary practice location
1220 Plumas St
Yuba City, CA 95991-3411
Mailing address
262 N University Ave Ste 200
Farmington, UT 84025-2975
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275923773 | Medicaid | CA |
Other names
- Yuba City Post-Acute
Other providers in Yuba City, CA
- Kylie Nevaeh Griffith
- Sara Kathleen Griffith
- Megan Grimes
- Dristie Jahnean Grundmann
- Guardian Medical Services
- Mellissa Rose Kiana Guillermo
- Arpana Gupta
- Rahul Gupta
- Vineet Gupta
- Guru Nanak Dental Inc
All providers in Yuba City, 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 Aug 20, 2024. 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.