2030 Harper Avenue Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

2030 HARPER AVENUE OPCO LLC

Doing business as

Hibriten Mountain Nursing and Rehabilitation

Practice address

2030 Harper Ave NW
Lenoir, NC 28645-4953

Phone

(828) 754-3888

NPI assigned

Dec 23, 2024

Last updated

Mar 10, 2025By 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

Tiffany Hoback

Title

Manager

Phone

(770) 698-9040

Specialties & licenses 1

Addresses

Other names 1

• Hibriten Mountain Nursing and Rehabilitation Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497563431. Details of each certification follow.

• CCN 345329 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 345329

Legal name

2030 HARPER AVENUE OPCO LLC

Doing business as

HIBRITEN MOUNTAIN NURSING AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 3, 1990

Last certification

Dec 17, 2024

Beds

100

Ownership / control type

Other Nonprofit

Multi-facility organization

Avardis Health

Organization structure

LLC

Enrollment address

2030 Harper Ave NW
Lenoir, NC 28645-4953

Nursing home name

HIBRITEN MOUNTAIN NURSING AND REHABILITATION

Affiliated entity

AVARDIS HEALTH

Listed as

Hibriten Mountain Nursing and RehabilitationCCN 345329 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Oct 3, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10083.0 residents per day on average

Chain

Avardis Health38 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $53,110

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 21

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

Owners & managing parties with NPI records 1

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

• Kevin R Clark, DO

  • General Practice Physician
  • Hickory, NC
  • NPI 1053373399

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 41

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

• 1000 Tandall Place Opco LLC

  dba Wellington Rehabilitation and Healthcare

  • Skilled Nursing Facility
  • Knightdale, NC
  • NPI 1790593648

  SNF MGR LLC

  CMS ownership
• 1810 Concord Lake Road Opco LLC

  dba Kannapolis Health and Rehabilitation

  • Skilled Nursing Facility
  • Kannapolis, NC
  • NPI 1114735156

  SNF MGR LLC

  CMS ownership
• 25 Reynolds Mountain Boulevard Opco LLC

  dba Emerald Ridge Health and Rehabilitation

  • Skilled Nursing Facility
  • Asheville, NC
  • NPI 1548078652

  SNF MGR LLC

  CMS ownership
• 333 East Lee Avenue Opco LLC

  dba Willowbrook Rehabilitation and Care

  • Skilled Nursing Facility
  • Yadkinville, NC
  • NPI 1669280517

  SNF MGR LLC

  CMS ownership
• 3864 Sweeten Creek Road Opco LLC

  dba Arden Ridge Health and Rehabilitation

  • Skilled Nursing Facility
  • Arden, NC
  • NPI 1548078595

  SNF MGR LLC

  CMS ownership
• 511 Windmill Street Opco LLC

  dba Walnut Cove Health and Rehabilitation

  • Skilled Nursing Facility
  • Walnut Cove, NC
  • NPI 1164230017

  SNF MGR LLC

  CMS ownership
• 518 Old US Highway 221 Opco LLC

  dba Oak Grove Healthcare

  • Skilled Nursing Facility
  • Rutherfordton, NC
  • NPI 1427866474

  SNF MGR LLC

  CMS ownership
• 551 Kent Street Opco LLC

  dba Valley View Care and Rehabilitation

  • Skilled Nursing Facility
  • Andrews, NC
  • NPI 1437967387

  SNF MGR LLC

  CMS ownership
• 6001 Wilora Lake Road Opco LLC

  dba Wilora Lake Healthcare

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1831907781

  SNF MGR LLC

  CMS ownership
• 620 Heathwood Drive Opco LLC

  dba Forrest Oakes Healthcare

  • Skilled Nursing Facility
  • Albemarle, NC
  • NPI 1316755424

  SNF MGR LLC

  CMS ownership
• 620 Tom Hunter Road Opco LLC

  dba Crown Haven Health and Rehabilitation

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1760290704

  SNF MGR LLC

  CMS ownership
• 625 Ashland Street Opco LLC

  dba Westwood Health and Rehabilitation

  • Skilled Nursing Facility
  • Archdale, NC
  • NPI 1427866375

  SNF MGR LLC

  CMS ownership

Affiliated clinicians 1

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

• Kevin R Clark, DO

  • General Practice Physician
  • Hickory, NC
  • NPI 1053373399

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1497563431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 HARPER AVE NW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286454953",
            "telephone_number": "828-754-3888",
            "fax_number": "828-754-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 HARPER AVE NW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286454953",
            "telephone_number": "828-754-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2030 HARPER AVENUE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "HOBACK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-698-9040"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Synergy Healthcare Services",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hibriten Mountain Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A New Dimension Substance Abuse Counseling Service
• A Primary Choice, Inc.
• Elie Abboud, DDS
• Wendy L Abee, PTA
• Marlena Abernethy-Page, PHARMD

• Skilled Nursing Facility in Lenoir, NC
• Providers in Lenoir, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.