NPIMap

Organization Active NPI

Moreno Valley SNF, LLC

Doing business as Rancho Bellagio Post Acute

  • Skilled Nursing Facility
  • Moreno Valley, CA
National Provider Identifier
1285297291
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MORENO VALLEY SNF, LLC
Doing business as
Rancho Bellagio Post Acute
Practice address
26940 E Hospital Road
Moreno Valley, CA 92555-3923
Phone
(951) 363-5434
NPI assigned
Apr 16, 2019
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

26940 E Hospital Road
Moreno Valley, CA 92555-3923

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Rancho Bellagio 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
O20190530000889 CA Part A Provider - Skilled Nursing Facility 8820331184 Practice locations: Moreno Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285297291. Details of each certification follow.

Skilled nursing facility certification: CCN 555921

Legal name
MORENO VALLEY SNF LLC
Doing business as
RANCHO BELLAGIO POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 6, 2020
Last certification
Dec 12, 2024
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Mar 16, 2018 in CA
Enrollment address
26940 E Hospital Rd
Moreno Valley, CA 92555-3923
Nursing home name
RANCHO BELLAGIO POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rancho Bellagio Post AcuteCCN 555921 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 6, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9991.4 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $8,827

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
05D2172587Rancho Bellagio Post Acute26940 E Hospital Road, Moreno Valley, CA 92555Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Carson McCusker Individual W-2 Managing EmployeeAd; May 1, 2023
Operational/Managerial ControlAdministrator May 1, 2023
Alejandra Arambula Individual Contracted Managing EmployeeMD; Feb 27, 2023
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
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%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo . Jan 1, 2024

Facilities with the same owner 186

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

View all 186

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1285297291",
    "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": "26940 E HOSPITAL ROAD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553923",
            "telephone_number": "951-363-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORENO VALLEY SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rancho Bellagio Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rancho Bellagio Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.