NPIMap

Organization Active NPI

Sunnyvale Community Healthcare, LLC

Doing business as Sunnyvale Gardens Post Acute

  • Skilled Nursing Facility
  • Sunnyvale, CA
National Provider Identifier
1326740119
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SUNNYVALE COMMUNITY HEALTHCARE, LLC
Doing business as
Sunnyvale Gardens Post Acute
Practice address
1150 Tilton Dr
Sunnyvale, CA 94087-2440
Phone
(408) 735-7200
NPI assigned
Mar 17, 2023
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

1150 Tilton Dr
Sunnyvale, CA 94087-2440

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Sunnyvale Gardens 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
O20240604003812 CA Part A Provider - Skilled Nursing Facility 7113469222 Practice locations: Sunnyvale, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326740119. Details of each certification follow.

Skilled nursing facility certification: CCN 555444

Legal name
SUNNYVALE COMMUNITY HEALTHCARE LLC
Doing business as
SUNNYVALE GARDENS POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 3, 1991
Last certification
Nov 18, 2024
Beds
140
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS
Most recent change of ownership
Dec 21, 2007
Organization structure
LLCProprietary
Incorporated
Mar 10, 2023 in CA
Enrollment address
1150 Tilton Dr
Sunnyvale, CA 94087-2440
Nursing home name
SUNNYVALE GARDENS POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Sunnyvale Gardens Post AcuteCCN 555444 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 3, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140135.0 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
2Fines totaling $43,176

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
05D0678786Sunnyvale Gardens Post Acute1150 Tilton Drive, Sunnyvale, CA 94087Certificate of waiverApr 10, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, Holding company Adp of the SNF Oct 10, 2025
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2024 50%
John T Mitchell Individual Operational/Managerial Control Jan 1, 2024
Managing Control - Governing BodySecretary May 10, 2024
Robert S Pierce Individual Operational/Managerial Control Jun 14, 2024
Adp of the SNF Oct 10, 2025
Mehran Jamali Individual Operational/Managerial Control Mar 1, 2024
Adp of the SNF Sep 2, 2025
Frederick G Apt Individual Operational/Managerial Control Jan 1, 2024
Managing Control - Governing BodyManager/Treasurer May 10, 2024
Maria Daquigan Individual Operational/Managerial Control Mar 11, 2024
Organization, Suffern, NY LLC Adp of the SNF Jul 28, 2023
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Providence Administrative Consulting Services Inc Organization, Farmington, UT Corporation, Consulting firm Adp of the SNF Feb 1, 2024
Truist Bank Organization, Charlotte, NC Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Dec 7, 2023 100%
Joshua O Jergensen Individual Operational/Managerial Control Jan 1, 2024
Managing Control - Governing BodyManager, President May 10, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Mar 10, 2023 35.2%

Owners & managing parties with NPI records 1

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

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

Practitioners 1

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 1

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": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1326740119",
    "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": "1150 TILTON DR",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872440",
            "telephone_number": "408-735-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYVALE COMMUNITY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "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": "Sunnyvale Gardens Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sunnyvale Gardens Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.