Active NPI
Lowers Holdings LLC
- Skilled Nursing Facility
- Lacey, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- LOWERS HOLDINGS LLC
- Practice address
- 1505 Carpenter Rd SE
Lacey, WA 98503-2906 - Phone
- (360) 491-1765
- NPI assigned
- Dec 18, 2019
- Last updated
- Dec 18, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kirkman Lindahl
- Title
- Manager
- Phone
- (949) 697-6456
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
1505 Carpenter Rd SE
Lacey, WA 98503-2906
Mailing address
1520 N El Camino Real Ste 6
San Clemente, CA 92672-5957
Phone (949) 697-6456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200211002486 | WA | Part A Provider - Skilled Nursing Facility | 0143656140 | Practice locations: Lacey, WA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1346888591. Details of each certification follow.
Skilled nursing facility certification: CCN 505254
- Legal name
- LOWERS HOLDINGS LLC
- Doing business as
- ROO LAN HEALTH & REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1980
- Last certification
- Feb 6, 2025
- Beds
- 96
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Foundation Healthcare Services LLC
- Organization structure
- LLC
- Enrollment address
- 1505 Carpenter Rd SE
Lacey, WA 98503-2906 - Nursing home name
- CRYSTAL COVE POST ACUTE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Crystal Cove Post Acute
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 1, 1980
- Medicare certification status
- Active
- Certified beds
- 96
- Special focus status
- SFF
- Penalties (3 years)
- 6
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0636832 | Roo-Lan Health and Rehab | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryLocations
1520 N El Camino Real
Ste 6
San Clemente, CA 92672
1505 Carpenter Rd SE
Lacey, WA 98503
Phone (360) 491-1765
Ownership & related parties
All disclosed owners & managing parties 19
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Achashman Berihun | Operational/Managerial Control | Feb 1, 2020 | |
| Adp of the SNF | Feb 1, 2020 | ||
| Scott Lindahl | 5% Or Greater Indirect Ownership Interest | Mar 1, 2020 | 25% |
| Corporate Officer | Mar 1, 2020 | 25% | |
| Operational/Managerial Control | Feb 1, 2019 | ||
| Adp of the SNF | Mar 1, 2020 | ||
| John Maina | Operational/Managerial Control | Mar 27, 2025 | |
| Adp of the SNF | Mar 27, 2025 | ||
| Foundation Healthcare Services LLC | 5% Or Greater Direct Ownership Interest | Mar 1, 2020 | 100% |
| Chukwuemeka Nwankwo | Operational/Managerial Control | Apr 1, 2025 | |
| Adp of the SNF | Apr 1, 2025 | ||
| David Lindahl | Adp of the SNF | Mar 1, 2020 | |
| Foundation Resource Center LLC | Operational/Managerial Control | Feb 1, 2020 | |
| Adp of the SNF | Feb 11, 2025 | ||
| Brandt Anderson | Operational/Managerial Control | Jan 2, 2022 | |
| Adp of the SNF | Jan 2, 2022 | ||
| Wa1West LLC | Adp of the SNF | Feb 1, 2020 | |
| Steven Frost | 5% Or Greater Indirect Ownership Interest | Mar 1, 2020 | 25% |
| Corporate Officer | Mar 1, 2020 | 25% | |
| Operational/Managerial Control | Feb 1, 2020 | ||
| Adp of the SNF | Feb 1, 2020 | ||
| Kirkman Lindahl | 5% Or Greater Indirect Ownership Interest | Mar 1, 2020 | 25% |
| Corporate Officer | Mar 1, 2020 | 25% | |
| Operational/Managerial Control | Feb 1, 2019 | ||
| Adp of the SNF | Mar 1, 2020 | ||
| Adp of the SNF | Sep 9, 2025 | ||
| Brianna de Oro | Operational/Managerial Control | Feb 24, 2025 | |
| Adp of the SNF | Feb 24, 2025 | ||
| Adp of the SNF | Sep 9, 2025 | ||
| Jay Zwahlen | Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Adp of the SNF | Sep 9, 2025 | ||
| Jeffrey Lindahl | 5% Or Greater Indirect Ownership Interest | Feb 1, 2019 | 25% |
| Corporate Officer | Mar 1, 2020 | ||
| Operational/Managerial Control | Feb 1, 2019 | ||
| Adp of the SNF | Feb 1, 2019 | ||
| McKennzie Bracy | Operational/Managerial Control | Feb 1, 2020 | |
| Adp of the SNF | Feb 1, 2020 | ||
| Chateau Johnson | Operational/Managerial Control | Dec 30, 2024 | |
| Adp of the SNF | Dec 30, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Primary Care Clinic/Center
- Tacoma, WA
- NPI 1063199842
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Auburn, WA
- NPI 1346873130
Foundation Resource Center LLC
-
- Skilled Nursing Facility
- North Bend, WA
- NPI 1952982894
Foundation Resource Center LLC
-
- Skilled Nursing Facility
- Cashmere, WA
- NPI 1598234577
Foundation Healthcare Services LLC, Foundation Resource Center LLC
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Internal Medicine Physician
- Olympia, WA
- NPI 1447280334
-
- Primary Care Clinic/Center
- Tacoma, WA
- NPI 1063199842
-
- Adolescent Medicine (Family Medicine) Physician
- University Place, WA
- NPI 1790803443
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": "1576627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576627200000",
"number": "1346888591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 N EL CAMINO REAL STE 6",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926725957",
"telephone_number": "949-697-6456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 CARPENTER RD SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985032906",
"telephone_number": "360-491-1765"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOWERS HOLDINGS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-18",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A",
"authorized_official_last_name": "LINDAHL",
"authorized_official_first_name": "KIRKMAN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "949-697-6456"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.