NPIMap

Organization Active NPI

Utica Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Davenport, IA
National Provider Identifier
1497469563
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
UTICA SKILLED NURSING FACILITY LLC
Practice address
3800 Commerce Blvd
Davenport, IA 52807-3495
Phone
(563) 344-2000
NPI assigned
Jan 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 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) 676-5331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3800 Commerce Blvd
Davenport, IA 52807-3495

Mailing address

3450 Oakton St
Skokie, IL 60076-2951

Other names 1

  • Harmony Utica Ridge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230531002492 IA Part A Provider - Skilled Nursing Facility 3072970342 Practice locations: Davenport, IA

Skilled nursing facility certification: CCN 165575

Legal name
UTICA SKILLED NURSING FACILITY LLC
Doing business as
HARMONY UTICA RIDGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 9, 2009
Last certification
Apr 21, 2025
Beds
115
Ownership / control type
Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Incorporated
Dec 13, 2022 in IA
Enrollment address
3800 Commerce Blvd
Davenport, IA 52807-3495
Nursing home name
HARMONY UTICA RIDGE
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Harmony Utica RidgeCCN 165575
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 9, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11593.9 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Penalties (3 years)
2Fines totaling $51,292

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
16D1093554Harmony Utica Ridge3800 Commerce Boulevard, Davenport, IA 52807Certificate of waiverDec 21, 2026

National Provider Directory

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
Menachem Shabat Individual Corporate OfficerPresident Apr 1, 2023
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Apr 1, 2023 59.5%
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, Management services company, For-profit Operational/Managerial Control Apr 1, 2023
Oakway Operations LLC Organization, Skokie, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Apr 1, 2023 15%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Apr 1, 2023 25.5%
Sheri Burken Individual W-2 Managing EmployeeAdministrator Apr 1, 2023

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

Affiliated clinicians 1

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": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1497469563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 COMMERCE BLVD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073495",
            "telephone_number": "563-344-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTICA SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-676-5331"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harmony Utica Ridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harmony Utica Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.