7001 Charles Street Opco LLC
Organization Active NPI Skilled Nursing Facility · Towson, MD
NPI 1457051344 · NPPES record last updated Mar 8, 2023
Key facts
- NPI
- 1457051344
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 7001 CHARLES STREET OPCO LLC
- Practice address
- 7001 N Charles St
Towson, MD 21204-3730 - Phone
- (410) 337-8313
- NPI assigned
- Mar 8, 2023
- Organization subpart
- No
Authorized official
- Name
- Sam Stern
- Title
- Cfo
- Phone
- (877) 567-0402
Owners & managing parties with NPI records 1
-
Sunniya Khan, M.B, B.S, M.D
Facilities with the same owner 8
Practitioners 5
-
Anuradha A Arun, M.D.
-
Cyrus Hossin Asadi, D.O.
-
Dorothy M Seay, M.D.
Affiliated clinicians 4
-
Dorothy M Seay, M.D.
-
Alina R. Alfirii, MD
Medicare Care Compare: Nursing home
- Listed as
- Autumn Lake Healthcare at Ruxton
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 22, 1970
- Medicare certification status
- Active
- Certified beds
- 179 · 162.6 residents per day on average
- Chain
- Autumn Lake Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Skilled nursing facility certification: CCN 215077
- Legal name
- 7001 CHARLES STREET OPCO LLC
- Doing business as
- AUTUMN LAKE HEALTHCARE AT RUXTON
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 22, 1970
- Last certification
- Oct 24, 2024
- Beds
- 179
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jun 1, 2023 in MD
- Enrollment address
- 7001 N Charles St
Towson, MD 21204-3730 - Nursing home name
- AUTUMN LAKE HEALTHCARE AT RUXTON
- Affiliated entity
- AUTUMN LAKE HEALTHCARE
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| M Meisels Family Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 37.5% |
| Adp of the SNF | Apr 1, 2023 | ||
| Brand Sonnenschine LLP |
Adp of the SNF | May 1, 2023 | |
| 7001 Charles Street Holdco LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2023 | 100% |
| Sunniya Khan |
Adp of the SNF | Dec 1, 2024 | |
| Accurate Staffing LLC |
Adp of the SNF | May 1, 2023 | |
| As Family SD Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 57.95% |
| Adp of the SNF | Apr 1, 2023 | ||
| Tzvi Golub |
Operational/Managerial Control | May 15, 2023 | |
| Adp of the SNF | May 15, 2023 | ||
| Mark Schwartz |
Corporate Officer |
May 1, 2023 | |
| Operational/Managerial Control | May 1, 2023 | ||
| 7001 Charles Street Propco LLC |
5% Or Greater Mortgage Interest | Apr 1, 2023 | 100% |
| Adp of the SNF | Apr 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230830000665 | MD | Part a Provider - Skilled Nursing Facility | 7214390806 | Practice locations: Towson, MD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | |||
| Skilled Nursing Facility | 314000000X | Yes | ||
| Respite Care | 385H00000X |
Addresses
Primary practice location
7001 N Charles St
Towson, MD 21204-3730
Mailing address
14C 53Rd St
Brooklyn, NY 11232-2644
Phone (877) 567-0402
Other providers in Towson, MD
- 1St Medical Pain Management Specialists
- 4 Trinity Support LLC
- 7700 York Road Operations LLC
- 7700 York Road Operations LLC
- A Brighter Day Counseling and Consulting Firm LLC
- A Fresh Pathway to Wellness
- A New Place Called Home
All providers in Towson, MD · Skilled Nursing Facility in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 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.