NPIMap

Organization Active NPI

Graceville Health Center LLC

Doing business as Graceville Health Center

  • Skilled Nursing Facility
  • Graceville, FL
National Provider Identifier
1346976842
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GRACEVILLE HEALTH CENTER LLC
Doing business as
Graceville Health Center
Practice address
1083 Sanders Ave
Graceville, FL 32440-1854
Phone
(850) 263-4447
NPI assigned
Jul 27, 2022
Last updated
Jul 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Authorized official

Name
Mayer Fischl
Title
Cfo
Phone
(718) 757-6399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1083 Sanders Ave
Graceville, FL 32440-1854

Mailing address

1083 Sanders Ave
Graceville, FL 32440-1854
Phone (850) 263-4447

Other names 1

  • Graceville Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230201002300 FL Part A Provider - Skilled Nursing Facility 8729459615 Practice locations: Graceville, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346976842. Details of each certification follow.

Skilled nursing facility certification: CCN 105662

Legal name
GRACEVILLE HEALTH CENTER LLC
Doing business as
GRACEVILLE HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1989
Last certification
Oct 24, 2024
Beds
180 (147 certified)
Ownership / control type
Individual
Organization structure
LLCProprietary
Incorporated
Jul 7, 2022 in FL
Enrollment address
1083 Sanders Ave
Graceville, FL 32440-1854
Nursing home name
GRACEVILLE REHABILITATION BY HARBORVIEW
Affiliated entity
BENJAMIN LANDA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Graceville Rehabilitation by HarborviewCCN 105662 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Sep 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
147142.9 residents per day on average
Chain
Benjamin Landa48 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
10D1082141Graceville Health Center, LLC1083 Sanders Ave, Graceville, FL 32440Certificate of waiverFeb 28, 2028

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 8

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

NameRoleSinceShare
Mayer Fischel Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%
Jennifer Peterson Individual W-2 Managing EmployeeAdministrator Oct 8, 2022 100%
ZBL-18 LLC Organization, Brooklyn, NY Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%
Mathew K Varghese Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%
Graceville Health Member, LLC Organization, Graceville, FL Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 7, 2022 100%
Premier 4 Opco Partners LLC Organization, Richmond, KY Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 8, 2022 100%
Benjamin Landa Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 70%
Corporate Officer Oct 8, 2022 100%
Flnho Capital Group LLC Organization, Mineola, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 8, 2022 70%

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

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": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1346976842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 SANDERS AVE",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401854",
            "telephone_number": "850-263-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 SANDERS AVE",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401854",
            "telephone_number": "850-263-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEVILLE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "FISCHL",
        "authorized_official_first_name": "MAYER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-757-6399"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Graceville Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Graceville, FL

Sources for this page

Verify at the official NPI Registry.