NPIMap

Organization Active NPI

Stanleytown Operations LLC

  • Skilled Nursing Facility
  • Bassett, VA
National Provider Identifier
1376117556
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
STANLEYTOWN OPERATIONS LLC
Doing business as
Stanleytown Health & Rehabilitation Center
Practice address
240 Riverside Dr
Bassett, VA 24055-4257
Phone
(276) 629-1772
NPI assigned
May 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Kennedy Flynn
Title
Administrator
Phone
(276) 629-1772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

240 Riverside Dr
Bassett, VA 24055-4257

Mailing address

240 Riverside Dr
Bassett, VA 24055-4257

Other names 1

  • Stanleytown Health & Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210823003341 VA Part A Provider - Skilled Nursing Facility 9335544717 Practice locations: Bassett, VA

Skilled nursing facility certification: CCN 495216

Legal name
STANLEYTOWN OPERATIONS LLC
Doing business as
STANLEYTOWN HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 6, 1990
Last certification
Apr 18, 2024
Beds
120
Ownership / control type
Partnership
Most recent change of ownership
May 28, 2021
Organization structure
Not SelectedProprietary
Incorporated
Mar 4, 2021 in NV
Enrollment address
240 Riverside Dr
Bassett, VA 24055-4257
Nursing home name
STANLEYTOWN HEALTH AND REHABILITATION CENTER
Affiliated entity
LIFEWORKS REHAB

Care Compare: Nursing home

Medicare Care Compare
Listed as
Stanleytown Health and Rehabilitation CenterCCN 495216 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Sep 6, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120113.8 residents per day on average
Chain
Lifeworks Rehab64 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Charles 1994 & Family LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 23.75%
Edward 1998 Family Grantor Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest May 28, 2021 22.56%
Charles 1994 Family Grantor Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest May 28, 2021 21.37%
Saul 2012 Family Grantor Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest May 28, 2021 22.56%
America West LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 100%
Charles 1994 LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 22.94%
Moshe Y Rajchenbach Individual Corporate Officer Mar 28, 2021
Redrock West LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 75%
Stanleytown Holdings LLC Organization, Lakewood, NJ LLC 5% Or Greater Direct Ownership Interest May 28, 2021 100%
Kennedy Flynn Individual W-2 Managing EmployeeAdministrator May 28, 2021 100%
Charles 1994 Family Grantor Trust Organization, Cleveland, OH 5% Or Greater Indirect Ownership Interest May 28, 2021 21.37%

Facilities with the same owner 40

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

View all 40

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": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1376117556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 RIVERSIDE DR",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240554257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 RIVERSIDE DR",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240554257",
            "telephone_number": "276-629-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEYTOWN OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "KENNEDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "276-629-1772"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanleytown Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bassett, VA

Sources for this page

Verify at the official NPI Registry.