NPIMap

Organization Active NPI

Palm Bay Medical Investors, LLC

Doing business as Life Care Center of Palm Bay

  • Skilled Nursing Facility
  • Palm Bay, FL
National Provider Identifier
1336165778
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF130471030 Issued in FL
Legal business name
PALM BAY MEDICAL INVESTORS, LLC
Doing business as
Life Care Center of Palm Bay
Practice address
175 Villa Nueva Ave NE
Palm Bay, FL 32907-2595
Phone
(321) 952-1818
Fax
(321) 952-1113
NPI assigned
Jul 15, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF130471030 FL Primary

Addresses

Primary practice location

175 Villa Nueva Ave NE
Palm Bay, FL 32907-2595

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 1

IdentifierTypeStateIssuer
026818600MedicaidFL

Other names 1

  • Life Care Center of Palm Bay Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031002000003 FL Part A Provider - Skilled Nursing Facility 8022920032 Practice locations: Palm Bay, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336165778. Details of each certification follow.

Skilled nursing facility certification: CCN 106060

Legal name
PALM BAY MEDICAL INVESTORS, LLC
Doing business as
LIFE CARE CENTER OF PALM BAY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 28, 2004
Last certification
Jan 9, 2025
Beds
141
Ownership / control type
Corporation
Multi-facility organization
Life Care Centers of America
Organization structure
LLCProprietary
Enrollment address
175 Villa Nueva Ave NE
Palm Bay, FL 32907-2595
Nursing home name
LIFE CARE CENTER OF PALM BAY
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of Palm BayCCN 106060 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 28, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
141132.2 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain

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
10D1016908Life Care Center of Palm Bay175 Villa Nueva Avenue, Palm Bay, FL 32907Certificate of waiverSep 10, 2027

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Hussien Abbasse Ballout Individual Operational/Managerial Control Aug 1, 2018
Adp of the SNF Mar 17, 2025
Forrest L Preston Individual 5% Or Greater Direct Ownership InterestMember Apr 16, 2003 98.67%
Adp of the SNF Feb 27, 2024
Indirect Ownership Interest Apr 16, 2003 1.33%
Terry Henry Individual Corporate OfficerAsst Treasurer of Management Co. Aug 16, 1999
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Feb 27, 2024
Todd Fletcher Individual Operational/Managerial Control Dec 13, 2024
Aubrey Preston Individual Operational/Managerial Control Dec 13, 2024
Willard Tarbet Individual Operational/Managerial Control Apr 23, 2018
Managing Control - Governing BodyAdministrator Apr 23, 2018
Adp of the SNF Mar 17, 2025
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Mar 17, 2025
Ellen Marie Hutchinson Individual Operational/Managerial Control Nov 22, 2024
Managing Control - Governing BodyDirector of Nursing Nov 22, 2024
Joan E Thurmond Individual Corporate OfficerAsst Secretary of Management Co. Jul 3, 2003
Cindy S Cross Individual Corporate OfficerVP/Asst Secretary of Management Co. Jul 2, 2003
Richard Swanker Individual Corporate OfficerChief Tax Officer of Management Co. Apr 1, 2011
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Jul 2, 2003
Adp of the SNF Mar 17, 2025
Aaron Preston Individual Operational/Managerial Control Nov 1, 2018
Managing Control - Governing BodyDivisional Vice President Nov 1, 2018
Palm Bay Medical Investors, LLC Organization, Cleveland, TN LLC, For-profit Operational/Managerial Control Apr 26, 2004
Adp of the SNF Feb 27, 2024
Lisa M Lay Individual Corporate OfficerSecretary of Management Company Feb 9, 2018
James Ziegler Individual Operational/Managerial Control Dec 13, 2024
Developers Investment Company II, Inc Organization, Cleveland, TN Corporation, For-profit Operational/Managerial Control Jun 14, 2006
Direct Ownership Interest Apr 16, 2003 1.33%

Owners & managing parties with NPI records 26

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

View all 26

Facilities with the same owner 193

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

View all 193

Practitioners & affiliated clinicians

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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1336165778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 VILLA NUEVA AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072595",
            "telephone_number": "321-952-1818",
            "fax_number": "321-952-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BAY MEDICAL INVESTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF130471030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026818600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Palm Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.