NPIMap

Organization Active NPI

Crsca HC, LLC

Doing business as Creekside Post Acute

  • Skilled Nursing Facility
  • Yucaipa, CA
National Provider Identifier
1285202549
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CRSCA HC, LLC
Doing business as
Creekside Post Acute
Practice address
35253 Avenue H
Yucaipa, CA 92399-5415
Phone
(909) 795-2476
Fax
(909) 457-6579
NPI assigned
Jun 14, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Steven Robert Powell, NHA
Title
Owner/President
Phone
(949) 981-8915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

35253 Avenue H
Yucaipa, CA 92399-5415

Mailing address

3281 E Guasti Rd Ste 700
Ontario, CA 91761-7643
Phone (949) 981-8915

Other names 1

  • CREEKSIDE POST ACUTE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210721001475 CA Part A Provider - Skilled Nursing Facility 4284037763 Practice locations: Yucaipa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285202549. Details of each certification follow.

Skilled nursing facility certification: CCN 055557

Legal name
CRSCA HC, LLC
Doing business as
CREEKSIDE POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1976
Last certification
Jun 7, 2024
Beds
59
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Rockwell Healthcare
Organization structure
OtherProprietary
Incorporated
Jan 5, 2021 in CA
Enrollment address
35253 Avenue H
Yucaipa, CA 92399-5415
Nursing home name
CREEKSIDE POST ACUTE
Affiliated entity
ROCKWELL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Creekside Post AcuteCCN 055557 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5951.7 residents per day on average
Chain
Rockwell Healthcare5 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 4

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

NameRoleSinceShare
Rockwell Healthcare LLC Organization, Ontario, CA LLC, Management services company, For-profit 5% Or Greater Direct Ownership Interest Jan 5, 2021 100%
Operational/Managerial Control Jul 1, 2021 100%
Evangeline B Powell Individual Corporate OfficerVice President Jul 1, 2021 100%
Operational/Managerial ControlVice President Jul 1, 2021 100%
Tanner Peterson Individual W-2 Managing EmployeeAdministrator Sep 11, 2023 100%
Ricky Cruz Villanueva Individual W-2 Managing EmployeeDirector of Nursing Sep 18, 2023 100%

Facilities with the same owner 4

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1285202549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3281 E GUASTI RD STE 700",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617643",
            "telephone_number": "949-981-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35253 AVENUE H",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995415",
            "telephone_number": "909-795-2476",
            "fax_number": "909-457-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRSCA HC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "949-981-8915",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CREEKSIDE POST ACUTE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CREEKSIDE POST ACUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.