Emmetsburg Ia Skilled Nursing Facility, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EMMETSBURG IA SKILLED NURSING FACILITY, LLC

Practice address

2405 21St St
Emmetsburg, IA 50536-2203

Phone

(712) 852-4266

NPI assigned

Nov 22, 2023

Last updated

Nov 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chaim Rajchenbach

Title

Principal

Phone

(847) 745-7000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386419067. Details of each certification follow.

• CCN 165352 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165352

Legal name

EMMETSBURG IA SKILLED NURSING FACILITY LLC

Doing business as

EMMETSBURG CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1997

Last certification

Sep 12, 2024

Beds

46

Ownership / control type

Corporation

Multi-facility organization

Legacy

Organization structure

LLCProprietary

Incorporated

Nov 13, 2023 in DE

Enrollment address

2405 21St St
Emmetsburg, IA 50536-2203

Nursing home name

EMMETSBURG CARE CENTER

Affiliated entity

LEGACY HEALTHCARE

Listed as

Emmetsburg Care CenterCCN 165352 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 1, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4641.4 residents per day on average

Chain

Legacy Healthcare89 facilities in the chain

Penalties (3 years)

1Fines totaling $25,695

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Emmetsburg Ia Skilled Nursing Facility LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Emmetsburg Ia Skilled Nursing Facility, LLC

  • In Home Supportive Care Agency
  • Emmetsburg, IA
  • NPI 1164252672
  NPD tax ID
• Emmetsburg Ia Skilled Nursing Facility, LLC

  • Assisted Living Facility
  • Emmetsburg, IA
  • NPI 1386419026
  NPD tax ID

All disclosed owners & managing parties 44

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

Owners & managing parties with NPI records 1

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

• Lee A Kamstra, M.D.

  • Family Medicine Physician
  • Orange City, IA
  • NPI 1164409215

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 87

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

• Allison Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Allison, IA
  • NPI 1538934229

  Legacy Healthcare Financial Services LLC

  CMS ownership
• Aplington Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Aplington, IA
  • NPI 1326813015

  Doros Generation Trust U/a/D 1/3/12, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Armstrong Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Armstrong, IA
  • NPI 1316712011

  Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC

  CMS ownership
• Battle Creek Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Battle Creek, IA
  • NPI 1487429189

  Doros Generation Trust U/a/D 1/3/12, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Belmond Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Belmond, IA
  • NPI 1982479671

  Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC

  CMS ownership
• Bloomfield Ia Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Bloomfield, IA
  • NPI 1093580821

  Doros Generation Trust U/a/D 1/3/12, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Britt Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Britt, IA
  • NPI 1851166557

  Doros Generation Trust U/a/D 1/3/12, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Cedar Rapids Skilled Nursing Facility LLC

  dba Harmony Cedar Rapids

  • Skilled Nursing Facility
  • Cedar Rapids, IA
  • NPI 1699489385

  Doros Generation Trust U/a/D 1/3/12, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Clear Lake Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Clear Lake, IA
  • NPI 1114792801

  Legacy Healthcare Financial Services LLC

  CMS ownership
• Davenport Skilled Nursing Facility LLC

  dba Harmony Davenport

  • Skilled Nursing Facility
  • Davenport, IA
  • NPI 1780398842

  Doros Generation Trust U/a/D 1/3/12, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Des Moines Skilled Nursing Facility LLC

  dba Harmony West Des Moines

  • Skilled Nursing Facility
  • West Des Moines, IA
  • NPI 1861106924

  Doros Generation Trust U/a/D 1/3/12, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Dubuque Skilled Nursing Facility LLC

  dba Harmony Dubuque

  • Skilled Nursing Facility
  • Dubuque, IA
  • NPI 1104530286

  Doros Generation Trust U/a/D 1/3/12, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Daunyale L Sporaa, DO

  • Family Medicine Physician
  • Emmetsburg, IA
  • NPI 1952312985

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1386419067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 21ST ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362203",
            "telephone_number": "712-852-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 21ST ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362203",
            "telephone_number": "712-852-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMETSBURG IA SKILLED NURSING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-745-7000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Emmetsburg, IA
• Providers in Emmetsburg, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.

Verify at the official NPI Registry.