Blair Street Operating Company, LLC
Organization Active NPI Skilled Nursing Facility · Thomasville, NC
NPI 1386416147 · NPPES record last updated Oct 25, 2023
Key facts
- NPI
- 1386416147
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- BLAIR STREET OPERATING COMPANY, LLC
- Practice address
- 1028 Blair St
Thomasville, NC 27360-4359 - Phone
- (336) 472-7771
- NPI assigned
- Oct 25, 2023
- Organization subpart
- No
Authorized official
- Name
- Yosef Emanuel
- Title
- Member
- Phone
- (917) 745-7945
Facilities with the same owner 11
Practitioners 1
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Magnolia Gardens Center for Nursing and Rehabilita
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Oct 31, 2002
- Medicare certification status
- Active
- Certified beds
- 120 · 97.5 residents per day on average
- Chain
- Alliance Health Group
- Penalties (3 years)
- 1 · fines totaling $16,153
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2112032 | Blair Street Operating Company, LLC | Certificate of waiver | Apr 19, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Skilled nursing facility certification: CCN 345520
- Legal name
- BLAIR STREET OPERATING COMPANY, LLC
- Doing business as
- MAGNOLIA GARDENS CENTER FOR NURSING AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 31, 2002
- Last certification
- Jul 11, 2024
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Alliance Health Group
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 18, 2023 in NC
- Enrollment address
- 1028 Blair St
Thomasville, NC 27360-4359 - Nursing home name
- MAGNOLIA GARDENS CENTER FOR NURSING AND REHABILITATION
- Affiliated entity
- ALLIANCE HEALTH GROUP
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Alignment Holdco LLC |
5% Or Greater Direct Ownership Interest | Aug 1, 2024 | 100% |
| Eric Parker |
Operational/Managerial Control | Aug 1, 2024 | |
| Coalition Group LLC |
5% Or Greater Indirect Ownership Interest | Aug 1, 2024 | 100% |
| Yosef Emanuel |
5% Or Greater Indirect Ownership Interest |
Aug 1, 2024 | 100% |
| Corporate Officer |
Aug 1, 2024 | ||
| Alliance Health Group LLC |
Operational/Managerial Control | Nov 22, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240909000913 | NC | Part a Provider - Skilled Nursing Facility | 4981144730 | Practice locations: Thomasville, NC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1028 Blair St
Thomasville, NC 27360-4359
Mailing address
1028 Blair St
Thomasville, NC 27360-4359
Phone (336) 472-7771
Other names
- Magnolia Gardens Center for Nursing and Rehabilitation
Other providers in Thomasville, NC
- Tammy Michelle Beard
- Michele Bell
- Benchmark Physical Therapy of NC, LLC
- Michayla Berard
- Taqiyyah Zafirah Betties
- Jacquelyn Blake
- Allison Paige Blankenship
- Ashley Wishon Blevins
- Samantha Lee Bolanos
- Anna Nicole Dockery Boles
All providers in Thomasville, NC · Skilled Nursing Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2023. 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.