100 W Queen Street Operations LLC
Organization Active NPI Skilled Nursing Facility · Dallastown, PA
NPI 1336859040 · NPPES record last updated Jan 6, 2023
Key facts
- NPI
- 1336859040
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 100 W QUEEN STREET OPERATIONS LLC
- Practice address
- 100 W Queen St
Dallastown, PA 17313-2133 - Phone
- (610) 444-6350
- NPI assigned
- Dec 5, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- GENESIS PM PA OPERATIONS LLC
Authorized official
- Name
- Michael Berg
- Title
- Asst Secretary
- Phone
- (505) 468-4742
Owners & managing parties with NPI records 1
-
Purvi Patel, MD
Facilities with the same owner 178
Practitioners 3
-
Faina V Caplan, MD
-
Purvi Patel, MD
-
Robert J. Pearlstein, D.O.
Affiliated clinicians 3
-
Faina V Caplan, MD
-
Angela Celentano, NP
-
Purvi Patel, MD
Medicare Care Compare: Nursing home
- Listed as
- Inners Creek Skilled Nursing and Rehabilitation Ce
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 17, 1979
- Medicare certification status
- Active
- Certified beds
- 202 · 184.6 residents per day on average
- Chain
- Genesis Healthcare
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 2 · fines totaling $47,031
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Skilled nursing facility certification: CCN 395451
- Legal name
- 100 W QUEEN STREET OPERATIONS LLC
- Doing business as
- INNERS CREEK SKILLED NURSING AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 17, 1979
- Last certification
- Oct 25, 2024
- Beds
- 202
- Ownership / control type
- Corporation
- Multi-facility organization
- 100 West Queen Street Operations
- Most recent change of ownership
- Feb 1, 2023
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 14, 2022 in PA
- Enrollment address
- 100 W Queen St
Dallastown, PA 17313-2133 - Nursing home name
- INNERS CREEK SKILLED NURSING AND REHABILITATION CE
- Affiliated entity
- GENESIS HEALTHCARE
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Laura Bridgeford |
Corporate Officer |
Jun 1, 2024 | 100% |
| HCCF Management Group XI LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 10.8% |
| Gen Operations I LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| Brandon M Sparver |
Operational/Managerial Control | Mar 11, 2024 | |
| Adp of the SNF | Feb 14, 2025 | ||
| Gen Operations II LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| Diane Louise Morris |
Operational/Managerial Control | Apr 1, 2024 | |
| FC-Gen Operations Investment LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| Sundance Rehabilitation Holdco Inc |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 5.2% |
| Genesis Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| Sun Healthcare Group Inc |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 65.3% |
| Welltower Op, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2023 | 5.7% |
| Genesis Healthcare Inc |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| Zac Properties XI LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 7.6% |
| |
Adp of the SNF | Feb 14, 2025 | |
| Avi Pinchas Mendelson |
Corporate Officer |
Jun 1, 2024 | 100% |
| Michael T Berg |
Corporate Officer |
Nov 14, 2022 | 100% |
| Genesis PM PA Operations LLC |
5% Or Greater Direct Ownership Interest | Nov 14, 2022 | 100% |
| GHC Holdings LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| Purvi J Patel |
Operational/Managerial Control | Feb 14, 2025 | |
| Adp of the SNF | Feb 14, 2025 | ||
| Genesis Holdings LLC |
5% Or Greater Indirect Ownership Interest | Nov 14, 2022 | 100% |
| |
Adp of the SNF | Feb 14, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230222001477 | PA | Part a Provider - Skilled Nursing Facility | 1759754781 | Practice locations: Dallastown, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
100 W Queen St
Dallastown, PA 17313-2133
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39-5451 | Other | MCR |
Other names
- DALLASTOWN SKILLED NURSING AND REHABILITATION CENTER
Other providers in Dallastown, PA
- 100 West Queen St. Opco, LLC
- 100 West Queen Street Opco LLC
- Jennifer A Anderson
- Rocco R Arcieri II
- Brandon John Bishop
All providers in Dallastown, PA · Skilled Nursing Facility in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.