NPIMap

Organization Active NPI

Mt. Vernon Operations, LLC

Doing business as Life Care Center of Mount Vernon

  • Skilled Nursing Facility
  • Mount Vernon, WA
National Provider Identifier
1356395545
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1393 Issued in WA
Legal business name
MT. VERNON OPERATIONS, LLC
Doing business as
Life Care Center of Mount Vernon
Practice address
2120 E Division St
Mount Vernon, WA 98274-4639
Phone
(360) 424-4258
Fax
(360) 428-5825
NPI assigned
May 20, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Cindy S. Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1393 WA Primary

Addresses

Primary practice location

2120 E Division St
Mount Vernon, WA 98274-4639

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 1

IdentifierTypeStateIssuer
4113932MedicaidWA

Other names 1

  • Life Care Center of Mount Vernon Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040707001219 WA Part A Provider - Skilled Nursing Facility 2365420353 Practice locations: Mount Vernon, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356395545. Details of each certification follow.

Skilled nursing facility certification: CCN 505272

Legal name
MT. VERNON OPERATIONS, LLC
Doing business as
LIFE CARE CENTER OF MOUNT VERNON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1982
Last certification
Apr 9, 2025
Beds
121
Ownership / control type
Corporation
Most recent change of ownership
Jan 1, 2006
Organization structure
LLCProprietary
Enrollment address
2120 E Division St
Mount Vernon, WA 98274-4639
Nursing home name
LIFE CARE CENTER OF MOUNT VERNON
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of Mount VernonCCN 505272 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12170.3 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
4Fines totaling $206,734

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
50D0860690Mt Vernon Care Center2120 E Division St, Mount Vernon, WA 98274Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Direct Ownership InterestMember Sep 19, 1995 99%
Adp of the SNF Aug 31, 2000
Indirect Ownership Interest Sep 19, 1995 1%
Terry Henry Individual Corporate OfficerAsst Treasurer of Management Co. Aug 16, 1999
Todd Fletcher Individual Operational/Managerial Control Dec 13, 2024
Developers Investment Company Inc Organization, Cleveland, TN Corporation, For-profit Operational/Managerial Control Jan 1, 2006
Direct Ownership Interest Sep 19, 1995 1%
Aubrey Preston Individual Operational/Managerial Control Dec 13, 2024
Masoud S Taleghani Individual Operational/Managerial Control Feb 1, 2024
Adp of the SNF Mar 21, 2025
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Aug 31, 2000
Heather R. Gordon Individual Operational/Managerial Control Feb 28, 2025
Managing Control - Governing BodyDirector of Nursing Feb 28, 2025
Andrea Roberts Individual Operational/Managerial Control Jan 13, 2025
Managing Control - Governing BodyAdministrator Jan 13, 2025
Adp of the SNF Mar 21, 2025
Joan E Thurmond Individual Corporate OfficerAsst Secretary of Management Co. Sep 22, 2000
Nancy Butner Individual Operational/Managerial Control Sep 16, 2018
Managing Control - Governing BodyDivisional Vice President Sep 16, 2018
Cindy S Cross Individual Corporate OfficerVP/Asst Secretary of Management Co. Sep 28, 1995
Richard Swanker Individual Corporate OfficerChief Tax Officer of Management Co. Apr 1, 2011
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Sep 28, 1995
Adp of the SNF Mar 20, 2025
Lisa M Lay Individual Corporate OfficerSecretary of Management Company Feb 9, 2018
James Ziegler Individual Operational/Managerial Control Dec 13, 2024

Owners & managing parties with NPI records 26

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 26

Facilities with the same owner 193

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

View all 193

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.

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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1356395545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E DIVISION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744639",
            "telephone_number": "360-424-4258",
            "fax_number": "360-428-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. VERNON OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113932",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Mount Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.