Active NPI
Kingseal LLC
- Skilled Nursing Facility
- Arcadia, FL
National Provider Identifier
1366873689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- KINGSEAL LLC
- Doing business as
- Desoto Health and rehab
- Practice address
- 475 Nursing Home Dr
Arcadia, FL 34266-3839 - Phone
- (863) 494-5766
- Fax
- (863) 494-9470
- NPI assigned
- Dec 12, 2013
- 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
- Mr. Louis Daniel Badenhorst
- Title
- Cfo
- Phone
- (813) 210-3238
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | FL | Primary |
Addresses
Primary practice location
475 Nursing Home Dr
Arcadia, FL 34266-3839
Mailing address
475 Nursing Home Dr
Arcadia, FL 34266-3839
Phone (863) 494-5766
Other names 1
- Desoto Health and rehab
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140221001269 | FL | Part A Provider - Skilled Nursing Facility | 3971733767 | Practice locations: Arcadia, FL |
Skilled nursing facility certification: CCN 106070
- Legal name
- KINGSEAL LLC
- Doing business as
- DESOTO HEALTH AND REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 29, 2006
- Last certification
- Nov 9, 2023
- Beds
- 118 (78 certified)
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Incorporated
- Dec 31, 2013 in FL
- Enrollment address
- 475 Nursing Home Dr
Arcadia, FL 34266-3839 - Nursing home name
- DESOTO HEALTH AND REHAB
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Desoto Health and Rehab
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 29, 2006
- Medicare certification status
- Active
- Certified beds
- 78
- Penalties (3 years)
- 1
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 |
|---|---|---|---|
| 10D0720161 | Kingseal LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Trustee of the SNF | Apr 2, 2017 | ||
| Adp of the SNF | Jan 21, 2025 | ||
| Trustee of the SNF | Jan 1, 2022 | ||
| Adp of the SNF | Jan 21, 2025 | ||
| Heloise Badenhorst | 5% Or Greater Direct Ownership Interest | Dec 31, 2013 | 100% |
| W-2 Managing Employee | Dec 31, 2013 | 100% | |
| Trustee of the SNF | Dec 31, 2013 | ||
| Adp of the SNF | Jan 21, 2025 |
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": "1386806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1386806400000",
"number": "1366873689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 NURSING HOME DR",
"city": "ARCADIA",
"state": "FL",
"postal_code": "342663839",
"telephone_number": "863-494-5766",
"fax_number": "863-494-9470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 NURSING HOME DR",
"city": "ARCADIA",
"state": "FL",
"postal_code": "342663839",
"telephone_number": "863-494-5766",
"fax_number": "863-494-9470"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KINGSEAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-12",
"last_updated": "2013-12-12",
"status": "A",
"authorized_official_last_name": "BADENHORST",
"authorized_official_first_name": "LOUIS",
"authorized_official_middle_name": "DANIEL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "813-210-3238",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Desoto Health and rehab",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Arcadia, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.