NPIMap

Organization Active NPI

Utah Lake Holdings LLC

  • Skilled Nursing Facility
  • San Diego, CA
National Provider Identifier
1326738345
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
UTAH LAKE HOLDINGS LLC
Practice address
4075 54TH St
San Diego, CA 92105-2301
Phone
(858) 798-5700
NPI assigned
May 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Toby Tilford
Title
Manager
Phone
(858) 798-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4075 54TH St
San Diego, CA 92105-2301

Mailing address

16544 Franzen Farm Rd
San Diego, CA 92127-2240
Phone (858) 798-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230811001434 CA Part A Provider - Skilled Nursing Facility 2264894948 Practice locations: San Diego, CA

Skilled nursing facility certification: CCN 055508

Legal name
UTAH LAKE HOLDINGS LLC
Doing business as
JACOB HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Sep 12, 2024
Beds
128
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Apr 5, 2023 in CA
Enrollment address
4075 54TH St
San Diego, CA 92105-2301
Nursing home name
JACOB HEALTHCARE CENTER
Affiliated entity
LINKS HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jacob Healthcare CenterCCN 055508 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
128119.5 residents per day on average
Chain
Links Healthcare Group32 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 3

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

NameRoleSinceShare
Toby Tilford Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2023 46%
Corporate OfficerManager Jun 1, 2023
W-2 Managing Employee Jun 1, 2023
Links Healthcare Group LLC Organization, San Diego, CA LLC 5% Or Greater Direct Ownership Interest Jun 1, 2023 100%
Curtis Rodriguez Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2023 46%
Corporate OfficerManager Jun 1, 2023

Facilities with the same owner 30

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

View all 30

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": "1683849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1326738345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16544 FRANZEN FARM RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272240",
            "telephone_number": "858-798-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 54TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921052301",
            "telephone_number": "858-798-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH LAKE HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "TILFORD",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "858-798-5700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.