NPIMap

Organization Active NPI

Huron SD Skilled Nursing Facility LLC

Doing business as Avantara Huron

  • Skilled Nursing Facility
  • Huron, SD
National Provider Identifier
1376190371
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HURON SD SKILLED NURSING FACILITY LLC
Doing business as
Avantara Huron
Practice address
1345 Michigan Ave SW
Huron, SD 57350-3029
Phone
(605) 352-7600
Fax
(605) 352-8255
NPI assigned
Aug 23, 2019
Last updated
Aug 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Authorized official

Name
Menachem Shabat
Title
Coo/Principal
Phone
(847) 679-9797

Specialties & licenses 1

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

Addresses

Primary practice location

1345 Michigan Ave SW
Huron, SD 57350-3029

Mailing address

3450 Oakton St
Skokie, IL 60076-2951
Phone (847) 679-9797

Other names 1

  • Avantara Huron Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191112003524 SD Part A Provider - Skilled Nursing Facility 4981036969 Practice locations: Huron, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376190371. Details of each certification follow.

Skilled nursing facility certification: CCN 435020

Legal name
HURON SD SKILLED NURSING FACILITY, LLC
Doing business as
AVANTARA HURON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 3, 1968
Last certification
Nov 14, 2024
Beds
119
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Enrollment address
1345 Michigan Ave SW
Huron, SD 57350-3029
Nursing home name
AVANTARA HURON
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avantara HuronCCN 435020 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 3, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11967.6 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Penalties (3 years)
1Fines totaling $8,338

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
43D0690820Avantara Huron1345 Michigan Ave Southwest, Huron, SD 57350Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1345 Michigan Ave SW
Huron, SD 57350
Phone (605) 352-8471

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Individual Indirect Ownership Interest Oct 2, 2019 4.9%
Bokf,NA Organization, Tulsa, OK Financial institution 5% Or Greater Security Interest Mar 4, 2024 100%
Operational/Managerial Control Mar 4, 2024
Individual Indirect Ownership Interest Oct 2, 2019 2.6%
Laurie Solem Individual Operational/Managerial Control Oct 2, 2019
Adp of the SNF Oct 2, 2019
Menachem Shabat Individual Operational/Managerial Control Oct 2, 2019
Managing Control - Governing BodyManager of the Manager Oct 2, 2019
Adp of the SNF Oct 2, 2019
Roth & Co, LLP Organization, Brooklyn, NY Consulting firm Adp of the SNF Jan 1, 2024
Individual Adp of the SNF Oct 2, 2019
Vincent Oyler Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Oct 2, 2019 42.5%
Adp of the SNF Oct 2, 2019
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, For-profit Operational/Managerial Control Oct 2, 2019
Adp of the SNF Nov 21, 2025
Oakway Operations LLC Organization, Skokie, IL LLC 5% Or Greater Direct Ownership Interest Oct 2, 2019 15%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Oct 2, 2019 42.5%
Adp of the SNF Oct 2, 2019
Huron SD Property Holdings, LLC Organization, Skokie, IL LLC 5% Or Greater Security Interest Oct 2, 2019 100%
Adp of the SNF Oct 2, 2019
Individual Indirect Ownership Interest Oct 2, 2019 4.9%
Individual Indirect Ownership Interest Oct 2, 2019 2.6%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 90

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

View all 90

Practitioners & affiliated clinicians

Practitioners 2

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": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1376190371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797",
            "fax_number": "847-679-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 MICHIGAN AVE SW",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573503029",
            "telephone_number": "605-352-7600",
            "fax_number": "605-352-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON SD SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "SHABAT",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "COO/PRINCIPAL",
        "authorized_official_telephone_number": "847-679-9797"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avantara Huron",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huron, SD

Sources for this page

Verify at the official NPI Registry.