NPIMap

Organization Active NPI

St. Joseph Transitional Rehabilitation Center, LLC

Doing business as St. Joseph Transitional Rehabilitation Center

  • Skilled Nursing Facility
  • Las Vegas, NV
National Provider Identifier
1346289113
Registry record updated Sep 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1182SNF-20 Issued in NV
Legal business name
ST. JOSEPH TRANSITIONAL REHABILITATION CENTER, LLC
Doing business as
St. Joseph Transitional Rehabilitation Center
Practice address
2035 W Charleston Blvd
Las Vegas, NV 89102-2223
Phone
(702) 386-7980
Fax
(702) 386-4833
NPI assigned
Jun 6, 2006
Last updated
Sep 6, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2017

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

Authorized official

Name
Michael T. Berg
Title
Assistant Secretary
Phone
(505) 468-4752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1182SNF-20 NV Primary

Addresses

Primary practice location

2035 W Charleston Blvd
Las Vegas, NV 89102-2223

Mailing address

2035 W Charleston Blvd
Las Vegas, NV 89102-2223
Phone (702) 386-7980

Other identifiers 1

IdentifierTypeStateIssuer
001902545MedicaidNV

Other names 1

  • St. Joseph Transitional Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060808000584 NV Part A Provider - Skilled Nursing Facility 0749283976 Practice locations: Las Vegas, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346289113. Details of each certification follow.

Skilled nursing facility certification: CCN 295040

Legal name
ST. JOSEPH TRANSITIONAL REHABILITATION CENTER, LLC
Doing business as
ST. JOSEPH TRANSITIONAL REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 19, 1988
Last certification
Sep 19, 2024
Beds
100
Ownership / control type
Limited Liability Corporation
Multi-facility organization
New Gen Administrative Services
Organization structure
LLCProprietary
Enrollment address
2035 W Charleston Blvd
Las Vegas, NV 89102-2223
Nursing home name
SAINT JOSEPH TRANSITIONAL REHABILITATION CENTER
Affiliated entity
GENESIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Saint Joseph Transitional Rehabilitation CenterCCN 295040 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 19, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10093.4 residents per day on average
Chain
Genesis Healthcare184 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
29D0879110St Joseph Transitional Rehabilitation Center2035 W Charleston Blvd, Las Vegas, NV 89102Certificate of waiverNov 9, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
9560 Pico LLC Organization, Los Angeles, CA For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 50%
Bold Quail Holdings LLC Organization, Los Angeles, CA Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 100%
Pico Ar LLC Organization, Los Angeles, CA For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 50%
BQ Realty Holdings LLC Organization, Los Angeles, CA LLC, Holding company, For-profit Adp of the SNF May 3, 2026
BQ Operations Holdings LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2021 100%
Newgen LLC Organization, Los Angeles, CA Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 100%
2035 West Charleston Boulevard Property LLC Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Feb 1, 2021
Avrohom L Tress Individual 5% Or Greater Indirect Ownership InterestVice President Feb 1, 2021 50%
Pamela Shaw Individual Operational/Managerial Control Feb 1, 2021
Aaron H Robin Individual 5% Or Greater Indirect Ownership InterestPresident Feb 1, 2021 50%

Facilities with the same owner 45

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

View all 45

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": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504656000000",
    "number": "1346289113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022223",
            "telephone_number": "702-386-7980",
            "fax_number": "702-386-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022223",
            "telephone_number": "702-386-7980",
            "fax_number": "702-386-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH TRANSITIONAL REHABILITATION CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT CARE LLC",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-09-06",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NV",
            "license": "1182SNF-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001902545",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Transitional Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.