GHC of El Cajon, LLC
Organization Active NPI Skilled Nursing Facility · El Cajon, CA
NPI 1356975684 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1356975684
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- GHC OF EL CAJON, LLC
- Practice address
- 675 E Bradley Ave
El Cajon, CA 92021-3110 - Phone
- (619) 448-6633
- NPI assigned
- Feb 25, 2020
- Organization subpart
- No
Authorized official
- Name
- Lois Mastrocola
- Title
- Chief Financial Officer
- Phone
- (714) 241-5600
Facilities with the same owner 27
Affiliated clinicians 1
-
Bernard Aron Michlin, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Bradley Court
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★★ 5 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 30, 1990
- Medicare certification status
- Active
- Certified beds
- 56 · 55.4 residents per day on average
- Chain
- Generations Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 555140
- Legal name
- GHC OF EL CAJON, LLC
- Doing business as
- BRADLEY COURT
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 30, 1990
- Last certification
- Mar 13, 2025
- Beds
- 56
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Life Generations Healthcare, LLC
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 13, 2020 in CA
- Enrollment address
- 675 E Bradley Ave
El Cajon, CA 92021-3110 - Nursing home name
- BRADLEY COURT
- Affiliated entity
- GENERATIONS HEALTHCARE
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Lois a Mastrocola |
5% Or Greater Indirect Ownership Interest |
Mar 1, 2020 | 9.18% |
| Corporate Officer |
Mar 1, 2020 | ||
| Corporate Director |
Mar 1, 2020 | ||
| W-2 Managing Employee | Mar 1, 2020 | ||
| Thomas Olds |
5% Or Greater Indirect Ownership Interest |
Mar 1, 2020 | 78.13% |
| Corporate Officer |
Mar 1, 2020 | ||
| Corporate Director |
Mar 1, 2020 | ||
| Fred Smith |
5% Or Greater Indirect Ownership Interest | Mar 1, 2020 | 12.69% |
| Life Generations Healthcare, LLC |
5% Or Greater Direct Ownership Interest | Mar 1, 2020 | 100% |
| Bmo Bank National Association |
5% Or Greater Security Interest | Sep 20, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200923001325 | CA | Part a Provider - Skilled Nursing Facility | 9739508862 | Practice locations: El Cajon, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
675 E Bradley Ave
El Cajon, CA 92021-3110
Mailing address
6 Hutton Centre Dr Ste 400
Santa Ana, CA 92707-8762
Phone (714) 241-5600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356975684 | Medicaid | CA |
Other names
- Bradley Special Care Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
NPI Registry JSON
{
"created_epoch": "1582588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722816000000",
"number": "1356975684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 HUTTON CENTRE DR STE 400",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927078762",
"telephone_number": "714-241-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 E BRADLEY AVE",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920213110",
"telephone_number": "619-448-6633"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GHC OF EL CAJON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-25",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A",
"authorized_official_last_name": "MASTROCOLA",
"authorized_official_first_name": "LOIS",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "714-241-5600"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356975684",
"state": "CA"
}
],
"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": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Bradley Special Care Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bradley Special Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in El Cajon, CA
- Scott Gerak
- Lauren Gerken
- Nada Ghaith
- Alana Reta Ghanim
- Ghassan Jayyar DDS PC
- Sara Ghebru
- Neli Ghorbani
- Jennifer Gibbs
- Riley Shea Giblin
- Alexis Gibson
All providers in El Cajon, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.