Active NPI
Town and Country Manor Christian & Missionary Alliance
- Skilled Nursing Facility
- Santa Ana, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- TOWN AND COUNTRY MANOR CHRISTIAN & MISSIONARY ALLIANCE
- Practice address
- 555 E Memory Lane
Santa Ana, CA 92706-1705 - Phone
- (714) 547-7581
- Fax
- (714) 547-0435
- NPI assigned
- Oct 17, 2005
- 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. Robert Goerzen
- Title
- Chief Executive Officer
- Phone
- (714) 547-7581
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 060000191 | CA | |
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
555 E Memory Lane
Santa Ana, CA 92706-1705
Mailing address
555 E Memory Lane
Santa Ana, CA 92706-1705
Phone (714) 547-7581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT 11308 F | Medicaid | CA |
Other names 1
- Town & Country
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100301000385 | CA | Part A Provider - Skilled Nursing Facility | 1850436957 | Practice locations: Santa Ana, CA |
Skilled nursing facility certification: CCN 555141
- Legal name
- TOWN AND COUNTRY MANOR CHRISTIAN & MISSIONARY ALLIANCE
- Doing business as
- TOWN & COUNTRY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 13, 1981
- Last certification
- Sep 13, 2024
- Beds
- 96
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Apr 27, 1973 in CA
- Enrollment address
- 555 E Memory LN
Santa Ana, CA 92706-1705 - Nursing home name
- TOWN & COUNTRY
- Affiliated entity
- THE CHRISTIAN AND MISSIONARY ALLIANCE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Town & Country
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Nov 13, 1981
- Medicare certification status
- Active
- Certified beds
- 96
- Chain
- The Christian and Missionary Alliance
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 |
|---|---|---|---|
| 05D0884431 | Town & Country Manor Healthcare Center | Certificate of waiver | Mar 30, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 26
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 |
|---|---|---|---|
| Miran Melendez | Operational/Managerial Control | Oct 2, 2000 | |
| Adp of the SNF | Oct 2, 2000 | ||
| Adp of the SNF | Nov 21, 2024 | ||
| John Adams | Corporate Director | Sep 22, 2024 | |
| Robert Yi | Corporate Director | Jan 1, 2013 | |
| Town and Country Manor Christian & Missionary Alliance | 5% Or Greater Direct Ownership Interest | Sep 17, 1976 | 100% |
| Adp of the SNF | Dec 6, 2024 | ||
| Adp of the SNF | Nov 21, 2024 | ||
| The Christian and Missionary Alliance | 5% Or Greater Indirect Ownership Interest | Sep 17, 1976 | 100% |
| Matthew Gerlach | Corporate Director | Jan 1, 2022 | |
| Ken Baldes | Corporate Director | Apr 1, 2021 | |
| Adp of the SNF | Nov 25, 2024 | ||
| David Moreland | Corporate Director | Jan 1, 2015 | |
| Robert Ellis | Corporate Director | Sep 1, 2015 | |
| Gina Kolb | Corporate Officer | Jan 20, 2013 | |
| Operational/Managerial Control | Jan 1, 2013 | ||
| Adp of the SNF | Jan 1, 2013 | ||
| Adp of the SNF | Nov 25, 2024 | ||
| Marissa Preciado | Operational/Managerial Control | Aug 16, 2016 | |
| Adp of the SNF | Aug 16, 2016 | ||
| Kari Walker | Corporate Director | Apr 1, 2017 | |
| Keith Crownover | Corporate Director | Apr 1, 2022 | |
| Aaron Wolff | Corporate Director | Apr 1, 2018 | |
| Pat Holt | Operational/Managerial Control | Feb 11, 2023 | |
| Adp of the SNF | Feb 11, 2023 | ||
| Wilford Kirk | Corporate Director | Apr 1, 2022 | |
| Adp of the SNF | Nov 21, 2024 | ||
| Joseph Lamendola | Corporate Director | Jan 1, 2015 | |
| Adp of the SNF | Nov 21, 2024 | ||
| Gordon Arthur Glasgow | Operational/Managerial Control | May 1, 1983 | |
| Adp of the SNF | Sep 1, 1998 | ||
| Robert J Goerzen | Corporate Officer | Aug 23, 2021 | |
| Operational/Managerial Control | Aug 23, 2021 | ||
| Adp of the SNF | Aug 23, 2021 | ||
| Rod Bollins | Corporate Director | Sep 1, 2007 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Cardiovascular Disease Physician
- San Juan Capistrano, CA
- NPI 1972619997
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Fort Myers, FL
- NPI 1669546321
The Christian and Missionary Alliance
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1129507200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731542400000",
"number": "1376532051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 E MEMORY LANE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927061705",
"telephone_number": "714-547-7581",
"fax_number": "714-547-0435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E MEMORY LANE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927061705",
"telephone_number": "714-547-7581",
"fax_number": "714-547-0435"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOWN AND COUNTRY MANOR CHRISTIAN & MISSIONARY ALLIANCE",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-17",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A",
"authorized_official_last_name": "GOERZEN",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "714-547-7581",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "CA",
"license": "060000191",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT 11308 F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Town & Country",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.