4405 Airline Drive Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

4405 AIRLINE DRIVE OPCO LLC

Practice address

4405 Airline Dr
Bossier City, LA 71111-2058

Phone

(318) 747-5440

Fax

(318) 747-5040

NPI assigned

Feb 27, 2024

Last updated

Aug 23, 2024By 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

Shlomo Mushell

Title

Manager

Phone

(917) 251-5131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437915477. Details of each certification follow.

• CCN 195247 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 195247

Legal name

4405 AIRLINE DRIVE OPCO LLC

Doing business as

ADIRA MEDICAL RESORT

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Jan 9, 1990

Last certification

Oct 17, 2024

Beds

77

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Pelican Care Centers

Organization structure

LLCProprietary

Enrollment address

4405 Airline Dr
Bossier City, LA 71111-2058

Nursing home name

ADIRA MEDICAL RESORT

Listed as

Adira Medical ResortCCN 195247 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare

Ownership

For profit - Limited Liability company

Certified

Jan 9, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7729.7 residents per day on average

Penalties (3 years)

1Fines totaling $8,281

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 8

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.

• Pat F Bass, M.D.

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1952321820

  Adp of the SNF, Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

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

• 2575 Airline Drive Opco LLC

  • Skilled Nursing Facility
  • Bossier City, LA
  • NPI 1710743752

  Airline Drive Bossier LLC, Doodle la Holdings, LLC, RMG Enterprises Solutions, Inc.

  CMS ownership

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1437915477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112058",
            "telephone_number": "318-747-5440",
            "fax_number": "318-747-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112058",
            "telephone_number": "318-747-5440",
            "fax_number": "318-747-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4405 AIRLINE DRIVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "MUSHELL",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-251-5131"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 2575 Airline Drive Opco LLC
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• A&L Health and Wellness Services
• Jordan Aarstad

• Skilled Nursing Facility in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.

Verify at the official NPI Registry.