NPIMap

Organization Active NPI

Stoneridge Senior Care LLC

Doing business as Avalon Health Care Center at StoneRidge

  • Skilled Nursing Facility
  • Mystic, CT
National Provider Identifier
1467436907
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2305 Issued in CT
Legal business name
STONERIDGE SENIOR CARE LLC
Doing business as
Avalon Health Care Center at StoneRidge
Practice address
186 Jerry Brown Rd
Mystic, CT 06355
Phone
(860) 572-5613
Fax
(860) 245-0551
NPI assigned
Nov 29, 2005
Last updated
Mar 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Martin E Steinberger
Title
Manager of Managing Member
Phone
(407) 999-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2305 CT Primary

Addresses

Primary practice location

186 Jerry Brown Rd
Mystic, CT 06355

Mailing address

186 Jerry Brown Rd
Mystic, CT 06355-4004
Phone (860) 536-9700

Other names 1

  • Avalon Health Care Center at StoneRidge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040910001037 CT Part A Provider - Skilled Nursing Facility 7416924311 Practice locations: Mystic, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467436907. Details of each certification follow.

Skilled nursing facility certification: CCN 075437

Legal name
STONERIDGE SENIOR CARE, LLC
Doing business as
AVALON HEALTH CARE CENTER AT STONERIDGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 24, 2004
Last certification
Sep 27, 2024
Beds
40
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
186 Jerry Browne Rd
Mystic, CT 06355-4004
Nursing home name
AVALON HEALTH CARE CENTER AT STONERIDGE
Affiliated entity
LIFE CARE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avalon Health Care Center at StoneridgeCCN 075437 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 24, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4036.4 residents per day on average
Chain
Life Care Services43 facilities in the chain
Penalties (3 years)
1Fines totaling $8,018

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
07D1030676Stoneridge Senior Care, LLC186 Jerry Browne Rd, Mystic, CT 06355Certificate of waiverSep 12, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 27

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

NameRoleSinceShare
John J Hennessey Individual Operational/Managerial Control May 1, 2024
Adp of the SNF Feb 17, 2025
Bank of America, N.a. Organization, Chicago, IL Financial institution 5% Or Greater Mortgage Interest Jan 1, 2025 100%
5% Or Greater Security Interest Jan 1, 2025 100%
Life Care Companies LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 9, 2016 100%
Patrick C. Cartier Individual Operational/Managerial ControlSNF Administrator Feb 27, 2023
Adp of the SNF Jan 30, 2025
Daniel L Lahey Individual Managing Control - Governing BodyExecutive Vice President Jan 1, 2025
LCS Milwaukee I LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest Mar 9, 2016 100%
Jason C Victor Individual Corporate OfficerSr. Vice President and Secretary Jan 1, 2025
Managing Control - Governing BodySr. Vice President and Treasurer Sep 1, 2022
Bridgette C Uhlemann Individual Managing Control - Governing BodySr. Vice President and Secretary Jan 1, 2025
Life Care Services LLC Organization, Des Moines, IA LLC, Management services company Operational/Managerial Control Jan 1, 2025
Adp of the SNF Feb 17, 2025
LCS Living LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2026 100%
Life Care Services Communities LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 9, 2016 100%
Gelynna Shaw Individual Managing Control - Governing BodyExecutive Vice President Jan 1, 2025
LCS Holding Company LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 28, 2021 100%
Indirect Ownership Interest Jan 1, 2025 100%
LCS Living Intermediate II LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2026 100%
Oak Investment Trust Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Jan 1, 2025 19.19%
Indirect Ownership Interest Jan 1, 2025 19.19%
LCS Living Intermediate I LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2026 100%
McCarthy Group LLC Organization, Omaha, NE LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 15, 2022 10.88%
Oak Investment Trust II Organization, Tampa, FL Indirect Ownership Interest Jan 1, 2025 51.55%
John Christopher Bird Individual Managing Control - Governing BodyPresident and Ceo Jan 1, 2025
Pamela Bukowski Klapproth Individual Operational/Managerial ControlExecutive Director Feb 27, 2023
LCS Management Holding Company LLC Organization, Des Moines, IA LLC, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2025 5.28%
Indirect Ownership Interest Jan 1, 2025 5.28%
Stoneridge JV LLC Organization, Hanover, MD LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 31, 2025 100%
Rci Legacy Holdings LLC Organization, Hanover, MD LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2025 33.49%
Indirect Ownership Interest Jan 1, 2025 33.49%
LCS Living Holdings LLC Organization, Des Moines, IA LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest May 1, 2026 100%
Redwood Holdings LLC Organization, Hanover, MD LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2025 33.17%
Indirect Ownership Interest Jan 1, 2025 33.17%
LCS CC Holdings Inc Organization, Omaha, NE Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2026 45.59%
MPM Senior Living Investors LLC Organization, Omaha, NE LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2025 15.64%
Indirect Ownership Interest Jan 1, 2025 15.64%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 119

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

View all 119

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1467436907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 JERRY BROWN RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063554004",
            "telephone_number": "860-536-9700",
            "fax_number": "860-536-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 JERRY BROWN RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-5613",
            "fax_number": "860-245-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONERIDGE SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "STEINBERGER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER OF MANAGING MEMBER",
        "authorized_official_telephone_number": "407-999-2400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Health Care Center at StoneRidge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.