NPIMap

Organization Active NPI

Battle Creek Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Battle Creek, IA
National Provider Identifier
1487429189
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BATTLE CREEK IA SKILLED NURSING FACILITY, LLC
Practice address
404 1St St
Battle Creek, IA 51006-9425
Phone
(712) 365-4332
NPI assigned
Nov 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Chaim Rajchenbach
Title
Principal
Phone
(847) 745-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

404 1St St
Battle Creek, IA 51006-9425

Mailing address

404 1St St
Battle Creek, IA 51006-9425
Phone (712) 365-4332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240923000430 IA Part A Provider - Skilled Nursing Facility 7113468836 Practice locations: Battle Creek, IA

Skilled nursing facility certification: CCN 165342

Legal name
BATTLE CREEK IA SKILLED NURSING FACILITY LLC
Doing business as
WILLOW DALE WELLNESS VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1997
Last certification
Nov 14, 2024
Beds
40
Ownership / control type
Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Enrollment address
404 1St St
Battle Creek, IA 51006-9425
Nursing home name
WILLOW DALE WELLNESS VILLAGE
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Willow Dale Wellness VillageCCN 165342
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4029.7 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Battle Creek Ia Skilled Nursing Facility LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

404 1st St
Battle Creek, IA 51006
Phone (712) 365-4332

Ownership & related parties

All disclosed owners & managing parties 40

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

NameRoleSinceShare
Amy Wright Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Sandra Staudt Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Mindy Houston Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Larina Heying Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Gorgona Sub Holdco LLC Organization, Skokie, IL LLC, Holding company Adp of the SNF Aug 15, 2024
Jenny Borcherding Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Joshua Seu Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Julie a Schiernbeck Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Jennifer Hedberg Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Albert M Veltri Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Laura Friedenberg Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Iowa Portfolio Opco Holdings LLC Organization, Skokie, IL Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 15, 2024 100%
Battle Creek Ia Property Holdings, LLC Organization, Skokie, IL LLC Adp of the SNF Aug 15, 2024
Menachem Shabat Individual 5% Or Greater Direct Ownership InterestPresident Aug 28, 2012 50%
Operational/Managerial Control Aug 15, 2024
Managing Control - Governing BodyPresident Aug 15, 2024
Adp of the SNF Aug 15, 2024
Patricia Otterbeck Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
MN8 RH Holdco LLC Organization, Skokie, IL LLC, Holding company Adp of the SNF Aug 15, 2024
Melissa Larson Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Chaim Rajchenbach Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Cascade Capital Holdings LLC Organization, Skokie, IL LLC, Holding company, For-profit Adp of the SNF Aug 15, 2024
Elizabeth Van Veghel Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Karla Beasley Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Indirect Ownership Interest Aug 15, 2024 45.5%
Trustee of the SNF Aug 15, 2024
Bobbie Wierschem Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, Management services company, For-profit Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Kiley Shear Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Oakway Operations LLC Organization, Skokie, IL LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 15, 2024 22.5%
Dorothy McClure Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Rosemary Wood Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Indirect Ownership Interest Aug 15, 2024 5%
Linsey Behounek Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Kathleen Scott Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
CCG Gorgona LLC Organization, Skokie, IL LLC, Holding company Adp of the SNF Aug 15, 2024
Holly Kinnaman Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Todd Riessen Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Sheri Burken Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Gorgona Propco Holdings LLC Organization, Skokie, IL LLC, Holding company Adp of the SNF Aug 15, 2024
Christina Hennager Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Michele Knutson Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Krystle Jaeger Individual Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Gorgona Holdco LLC Organization, Skokie, IL LLC, Holding company Adp of the SNF Aug 15, 2024

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 89

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

View all 89

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1487429189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 1ST ST",
            "city": "BATTLE CREEK",
            "state": "IA",
            "postal_code": "510069425",
            "telephone_number": "712-365-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 1ST ST",
            "city": "BATTLE CREEK",
            "state": "IA",
            "postal_code": "510069425",
            "telephone_number": "712-365-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATTLE CREEK IA SKILLED NURSING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-745-7000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, IA

Sources for this page

Verify at the official NPI Registry.