Evergreen SNF Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EVERGREEN SNF OPERATIONS LLC

Doing business as

Evergreen Health and Rehabilitation Center

Practice address

380 Millwood Ave
Winchester, VA 22601-4453

Phone

(540) 667-7010

NPI assigned

Jun 10, 2021

Last updated

Jun 10, 2021By 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

Joseph Lieberman

Title

Director of Financial Operations

Phone

(646) 275-4510

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Health and Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487221107. Details of each certification follow.

• CCN 495142 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 495142

Legal name

EVERGREEN SNF OPERATIONS LLC

Doing business as

EVERGREEN HEALTH & REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1984

Last certification

Jan 10, 2024

Beds

176

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Jul 1, 2021

Organization structure

LLCProprietary

Incorporated

Mar 17, 2021 in DE

Enrollment address

380 Millwood Ave
Winchester, VA 22601-4453

Nursing home name

EVERGREEN HEALTH AND REHABILITATION CENTER

Affiliated entity

HILL VALLEY HEALTHCARE

Listed as

Evergreen Health and Rehabilitation CenterCCN 495142 · All quality measures

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 1, 1984

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

176172.3 residents per day on average

Chain

Hill Valley Healthcare43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 13

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

Facilities with the same owner 47

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

• Alexandria SNF Operations LLC

  dba Alexandria Health & Rehabilitation

  • Skilled Nursing Facility
  • Alexandria, VA
  • NPI 1346951761

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Amherst SNF Operations LLC

  dba Fairmont Crossing Health and Rehab Center

  • Skilled Nursing Facility
  • Amherst, VA
  • NPI 1174297063

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Bedford SNF Operations LLC

  dba Oakwood Health and Rehab Center

  • Skilled Nursing Facility
  • Bedford, VA
  • NPI 1508530387

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Beth Sholom SNF Operations LLC

  dba Shalom Gardens Health & Rehabilitation

  • Skilled Nursing Facility
  • Richmond, VA
  • NPI 1881388510

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Blue Ridge SNF Operations LLC

  dba Blue Ridge Therapy Connection

  • Skilled Nursing Facility
  • Stuart, VA
  • NPI 1013478411

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Carlin Springs SNF Operations LLC

  dba Carlin Springs Health & Rehabilitation

  • Skilled Nursing Facility
  • Arlington, VA
  • NPI 1700597127

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Diamond Hill SNF Operations LLC

  dba Guggenheimer Health and Rehab Center

  • Skilled Nursing Facility
  • Lynchburg, VA
  • NPI 1679247563

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Fair Oaks SNF Operations LLC

  dba Fair Oaks Health & Rehabilitation

  • Skilled Nursing Facility
  • Fairfax, VA
  • NPI 1972214393

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Fork Union SNF Operations LLC

  dba Oakhurst Health & Rehabilitation

  • Skilled Nursing Facility
  • Fork Union, VA
  • NPI 1194441949

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Highland SNF Operations LLC

  dba Highland Ridge Rehab Center

  • Skilled Nursing Facility
  • Dublin, VA
  • NPI 1679034078

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Holly Manor SNF Operations LLC

  dba Holly Manor Rehab and Nursing

  • Skilled Nursing Facility
  • Farmville, VA
  • NPI 1235886607

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership
• Lakeside VA SNF Operations LLC

  dba Lakeside Health & Rehabilitation

  • Skilled Nursing Facility
  • Richmond, VA
  • NPI 1427769843

  Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

  CMS ownership

Affiliated clinicians 1

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

• Mustafa Rikabi, MD

  • Internal Medicine Physician
  • Ashburn, VA
  • NPI 1588077697

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1487221107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MILLWOOD AVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MILLWOOD AVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014453",
            "telephone_number": "540-667-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL OPERATIONS",
        "authorized_official_telephone_number": "646-275-4510"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Lynn Ettinger
• Eunice Medical Transportation Service LLC.
• Frances Russell Evans, M.D.
• Rachel Nicole Evans, BCBA
• Wayne Thomas Evans, PTA
• Tina W Eversole, ED.S.
• Emma Pitcock Everson, OTR/L
• Katie Everson, OTD, OTR/L
• Eye Associates of Winchester Inc.
• Ciara Fadeley

• Skilled Nursing Facility in Winchester, VA
• Providers in Winchester, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.