Organization Active NPI

GL Virginia Elizabeth House, LLC

Doing business as Elizabeth Adam Crump Health and Rehab

  • Skilled Nursing Facility
  • Glen Allen, VA
National Provider Identifier
1396289179
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GL VIRGINIA ELIZABETH HOUSE, LLC
Doing business as
Elizabeth Adam Crump Health and Rehab
Practice address
3600 Mountain Rd
Glen Allen, VA 23060-1930
Phone
(804) 672-8725
Fax
(804) 755-6863
NPI assigned
Dec 13, 2016
Last updated
Dec 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
David Rubenstein
Title
Paralegal
Phone
(404) 786-8528

Specialties & licenses 1

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

Addresses

Primary practice location

3600 Mountain Rd
Glen Allen, VA 23060-1930

Mailing address

3600 Mountain Rd
Glen Allen, VA 23060-1930
Phone (804) 672-8725

Other names 1

  • Elizabeth Adam Crump Health and Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170221000625 VA Part A Provider - Skilled Nursing Facility 2567746464 Practice locations: Glen Allen, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396289179. Details of each certification follow.

Skilled nursing facility certification: CCN 495299

Legal name
GL VIRGINIA ELIZABETH HOUSE LLC
Doing business as
ELIZABETH ADAM CRUMP HEALTH AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1995
Last certification
Aug 18, 2022
Beds
180
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Trio Healthcare
Most recent change of ownership
Dec 16, 2016
Organization structure
LLCProprietary
Incorporated
Oct 11, 2016 in GA
Enrollment address
3600 Mountain Rd
Glen Allen, VA 23060-1930
Nursing home name
ELIZABETH ADAM CRUMP HEALTH AND REHAB
Affiliated entity
TRIO HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Elizabeth Adam Crump Health and RehabCCN 495299 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180170.7 residents per day on average
Chain
Trio Healthcare9 facilities in the chain
Penalties (3 years)
1Fines totaling $9,011

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
49D0883619Elizabeth Adam Crump Health and Rehab3600 Mountain Road, Glen Allen, VA 23060Certificate of waiverMar 13, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Trio Healthcare Investors LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 16, 2016 100%
Boyd P Gentry Individual 5% Or Greater Indirect Ownership Interest Dec 16, 2016 42.9%
Corporate OfficerVice President Dec 16, 2016
Trio Health Care - East, LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest May 24, 2019 100%
Trio Healthcare LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 10, 2019 100%
GL Virginia Holdings LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 16, 2016 100%
Kenneth Byers Individual W-2 Managing EmployeeAdministrator Sep 12, 2023
David Rubenstein Individual 5% Or Greater Indirect Ownership Interest Dec 16, 2016 57.1%
Corporate OfficerPresident and Chief Executive of Dec 16, 2016

Facilities with the same owner 8

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

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": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1396289179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MOUNTAIN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230601930",
            "telephone_number": "804-672-8725",
            "fax_number": "804-755-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MOUNTAIN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230601930",
            "telephone_number": "804-672-8725",
            "fax_number": "804-755-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GL VIRGINIA ELIZABETH HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "RUBENSTEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PARALEGAL",
        "authorized_official_telephone_number": "404-786-8528"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elizabeth Adam Crump Health and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.