NPIMap

Organization Active NPI

Skyline Healthcare & Wellness Center, LLC

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1487970927
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000048 Issued in CA
Legal business name
SKYLINE HEALTHCARE & WELLNESS CENTER, LLC
Practice address
3032 Rowena Ave
Los Angeles, CA 90039-2005
Phone
(323) 665-1185
Fax
(323) 913-0796
NPI assigned
Apr 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
Moishe Frankel
Title
Administrator
Phone
(323) 828-3832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 970000048 CA Primary

Addresses

Primary practice location

3032 Rowena Ave
Los Angeles, CA 90039-2005

Mailing address

3032 Rowena Ave
Los Angeles, CA 90039-2005
Phone (323) 665-1185

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05783HMedicaidCA

Other names 1

  • Skyline Healthcare Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100604000543 CA Part A Provider - Skilled Nursing Facility 0547390338 Practice locations: Los Angeles, CA

Skilled nursing facility certification: CCN 555117

Legal name
SKYLINE HEALTHCARE & WELLNESS CENTER, LLC
Doing business as
SKYLINE HEALTHCARE CENTER - LOS ANGELES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 15, 1979
Last certification
May 22, 2025
Beds
99
Ownership / control type
Individual
Organization structure
LLCProprietary
Incorporated
Apr 5, 2010 in CA
Enrollment address
3032 Rowena Ave
Los Angeles, CA 90039-2005
Nursing home name
SKYLINE HEALTHCARE CENTER - LA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Skyline Healthcare Center - laCCN 555117
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Mar 15, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9984.1 residents per day on average
Special focus status
SFF Candidate
Penalties (3 years)
7Fines totaling $251,090

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
05D0866951Skyline Healthcare & Wellness Center, LLC3032 Rowena Ave, Los Angeles, CA 90039Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Grancare 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.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Rockport Administrative Services, LLC Organization, Los Angeles, CA LLC Operational/Managerial Control Dec 31, 2014
Adp of the SNF Apr 11, 2025
Michael Katiraie Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Menkel Enterprises LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 31, 2014 100%
Organization, Los Angeles, CA Adp of the SNF Dec 31, 2014
Kori Custado Individual Operational/Managerial Control Oct 2, 2023
Adp of the SNF Oct 2, 2023
Moishe Frankel Individual 5% Or Greater Indirect Ownership InterestManager Dec 31, 2014 100%
Operational/Managerial ControlManager Dec 31, 2014
Adp of the SNF Dec 31, 2014

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 70

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

View all 70

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 4

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": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1487970927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 ROWENA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392005",
            "telephone_number": "323-665-1185",
            "fax_number": "323-913-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 ROWENA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392005",
            "telephone_number": "323-665-1185",
            "fax_number": "323-913-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE HEALTHCARE & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "FRANKEL",
        "authorized_official_first_name": "MOISHE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-828-3832"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05783H",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Skyline Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skyline Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.