Organization Active NPI

1104 Welsh Road Operations LLC

Doing business as Chapel Manor

  • Skilled Nursing Facility
  • Philadelphia, PA
National Provider Identifier
1346422748
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
031602 Issued in PA
Legal business name
1104 WELSH ROAD OPERATIONS LLC
Doing business as
Chapel Manor
Practice address
1104 Welsh Rd
Philadelphia, PA 19115-3730
Phone
(215) 676-9191
Fax
(215) 676-1266
NPI assigned
Nov 28, 2007
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Michael T Berg
Title
Secretary
Phone
(610) 444-6350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 031602 PA Primary

Addresses

Primary practice location

1104 Welsh Rd
Philadelphia, PA 19115-3730

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436

Other identifiers 1

IdentifierTypeStateIssuer
1025697740001MedicaidPA

Other names 1

  • Chapel Manor Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080305000098 PA Part A Provider - Skilled Nursing Facility 4688759368 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346422748. Details of each certification follow.

Skilled nursing facility certification: CCN 395449B

Legal name
1104 WELSH ROAD OPERATIONS LLC
Doing business as
CHAPEL MANOR
Organization structure
LLCProprietary
Incorporated
Aug 21, 2007 in PA
Enrollment address
1104 Welsh Road
Chapel Manor
Philadelphia, PA 19115-3730
Nursing home name
CHAPEL MANOR
Affiliated entity
GENESIS HEALTHCARE

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Laura Bridgeford Individual Corporate OfficerTreasurer Jun 1, 2024 100%
HCCF Management Group XI LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2011 21%
Gen Operations I LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2011 100%
Stacy Omar Individual Operational/Managerial Control May 30, 2001
Adp of the SNF Feb 9, 2025
Gen Operations II LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2011 100%
Brian B Kimmel Individual Operational/Managerial Control Jan 1, 2009
Adp of the SNF Feb 9, 2025
FC-Gen Operations Investment LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2011 100%
Sundance Rehabilitation Holdco Inc Organization, Kennett Square, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 5.81%
Genesis Operations IV LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2011 100%
Genesis Healthcare LLC Organization, Kennett Square, PA LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2011 100%
Organization, Kennett Square, PA LLC, For-profit Adp of the SNF Feb 9, 2025
Sun Healthcare Group Inc Organization, Kennett Square, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 100%
Organization, Kennett Square, PA LLC, For-profit Adp of the SNF Feb 9, 2025
Welltower Op, LLC Organization, Toledo, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2022 5.7%
Arnold M Whitman Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2011 21%
Genesis Healthcare Inc Organization, Kennett Square, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 100%
Zac Properties XI LLC Organization, Jenkintown, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2011 12%
Steven E Fishman Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2011 11.4%
Avi Pinchas Mendelson Individual Corporate OfficerPresident and Cfo Jun 1, 2024 100%
Michael T Berg Individual Corporate OfficerSecretary Dec 1, 2012 100%
GHC Holdings LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2011 100%
Genesis Holdings LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 100%

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 178

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

View all 178

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1346422748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 WELSH RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153730",
            "telephone_number": "215-676-9191",
            "fax_number": "215-676-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1104 WELSH ROAD OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "610-444-6350"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "031602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025697740001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chapel Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.