NPIMap

Organization Active NPI

Brockton Rehabilitation and Nursing Center LLC

Doing business as Champion Rehabilitation and Nursing Center

  • Skilled Nursing Facility
  • Brockton, MA
National Provider Identifier
1306511852
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BROCKTON REHABILITATION AND NURSING CENTER LLC
Doing business as
Champion Rehabilitation and Nursing Center
Practice address
2 Beaumont Ave
Brockton, MA 02302-3302
Phone
(508) 588-8550
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Authorized official

Name
Mr. Akiva Horowitz
Title
Manager
Phone
(718) 974-0266

Specialties & licenses 1

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

Addresses

Primary practice location

2 Beaumont Ave
Brockton, MA 02302-3302

Mailing address

2 Beaumont Ave
Brockton, MA 02302-3302

Other names 1

  • Champion Rehabilitation and Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211209002648 MA Part A Provider - Skilled Nursing Facility 1759771538 Practice locations: Brockton, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306511852. Details of each certification follow.

Skilled nursing facility certification: CCN 225221

Legal name
BROCKTON REHABILITATION AND NURSING CENTER LLC
Doing business as
CHAMPION REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1974
Last certification
Aug 30, 2024
Beds
123
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Mar 6, 2020 in MA
Enrollment address
2 Beaumont Ave
Brockton, MA 02302-3302
Nursing home name
CHAMPION REHABILITATION AND NURSING CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Champion Rehabilitation and Nursing CenterCCN 225221 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
123115.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

2 Beaumont Ave
Brockton, MA 02302
Phone (508) 588-8500

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Organization, Bedmister, NJ Financial institution Adp of the SNF Jun 26, 2025
Bahige Asaker Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jul 14, 2025
Organization, Springfield, NJ LLC Adp of the SNF Nov 21, 2025
Matthew Reynolds Individual Operational/Managerial Control Mar 3, 2025
Managing Control - Governing BodyAdministrator Mar 3, 2025
Adp of the SNF Apr 8, 2025
Organization, Bensalem, PA Corporation, Management services company Adp of the SNF May 21, 2025
Organization, Quincy, MA Corporation, Management services company Adp of the SNF May 21, 2025
Organization, Howell, NJ LLC Adp of the SNF May 21, 2025
Akiva Horowitz Individual 5% Or Greater Direct Ownership Interest Jun 4, 2025 100%
Organization, Southfield, MI Corporation Adp of the SNF May 21, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 8

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 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": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1306511852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BEAUMONT AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BEAUMONT AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023302",
            "telephone_number": "508-588-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKTON REHABILITATION AND NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "HOROWITZ",
        "authorized_official_first_name": "AKIVA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-974-0266",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.