Meadowbrook Operator LLC
Organization Active NPI Skilled Nursing Facility · Tucker, GA
NPI 1508038753 · NPPES record last updated Jan 23, 2015
Key facts
- NPI
- 1508038753
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1-044-102 (GA)
- Legal business name
- MEADOWBROOK OPERATOR LLC
- Practice address
- 4608 Lawrenceville Hwy
Tucker, GA 30084-2903 - Phone
- (770) 491-9444
- Fax
- (770) 491-8760
- NPI assigned
- Mar 27, 2008
- Organization subpart
- No
Authorized official
- Name
- Michael W. Ostrozynski
- Title
- Administrator
- Phone
- (770) 491-9444
Corporate family (same tax ID) 1
Facilities with the same owner 38
Practitioners 2
-
Ellis Mossaded, M.D.
-
Neetu Singh, M.D.
Affiliated clinicians 2
-
Ellis Mossaded, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Tucker Park Crossing of Journey LLC
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 1, 1993
- Medicare certification status
- Active
- Certified beds
- 144 · 131.1 residents per day on average
- Chain
- Journey Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Skilled nursing facility certification: CCN 115561
- Legal name
- MEADOWBROOK OPERATOR LLC
- Doing business as
- MEADOWBROOK HEALTH AND REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1993
- Last certification
- Oct 31, 2024
- Beds
- 144
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- MISSION HEALTH COMMUNITIES, LLC
- Most recent change of ownership
- Feb 1, 2026
- Organization structure
- LLC · Proprietary
- Incorporated
- Mar 4, 2008 in FL
- Enrollment address
- 4608 Lawrenceville Hwy
Tucker, GA 30084-2903 - Nursing home name
- TUCKER PARK CROSSING OF JOURNEY LLC
- Affiliated entity
- JOURNEY HEALTHCARE
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Stuart D Lindeman |
5% Or Greater Indirect Ownership Interest | Jan 1, 2015 | 5% |
| Corporate Officer |
Jan 1, 2015 | 100% | |
| Jamie Yoakum |
Corporate Officer |
Mar 19, 2024 | |
| Operational/Managerial Control |
Mar 19, 2024 | ||
| Michelle Barnes |
W-2 Managing Employee |
Dec 1, 2018 | |
| Barres, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2015 | 5% |
| T and C Capital Assets, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2015 | 5% |
| GBD LLC |
5% Or Greater Direct Ownership Interest | Mar 4, 2008 | 5% |
| Operational/Managerial Control | Jan 1, 2015 | ||
| Joseph M Passero |
5% Or Greater Direct Ownership Interest | Jan 1, 2015 | 5% |
| Scott N Feuer |
5% Or Greater Direct Ownership Interest | Jan 1, 2015 | 32% |
| Mission Health of Georgia, LLC |
Operational/Managerial Control | Jan 1, 2015 | |
| Meadowbrook Operator LLC |
5% Or Greater Direct Ownership Interest | May 1, 2008 | 5% |
| Bryan L Crino |
5% Or Greater Direct Ownership Interest | Jan 1, 2015 | 33% |
| Windward Health Partners LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2015 | 5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080519000177 | GA | Part a Provider - Skilled Nursing Facility | 4789753658 | Practice locations: Tucker, GA |
National Provider Directory
- Tax ID family
- Meadowbrook Operator LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-044-102 | GA | Yes |
Addresses
Primary practice location
4608 Lawrenceville Hwy
Tucker, GA 30084-2903
Mailing address
4608 Lawrenceville Hwy
Tucker, GA 30084-2903
Phone (770) 491-9444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000141864A | Medicaid | GA |
Other names
- Meadowbrook Health and Rehab
Other providers in Tucker, GA
- Melissa McMillion
- Mia McMullen McMullen
- Lana McNair
- Dee A McNeily
- Meadowbrook Nursing Home Inc
- Meadows Med Group Inc
- Med-Corp EMS, Inc
- Medical Associates of Georgia
- Medicor Healthcare, Inc
- Mediquip Medical Supplies Inc
All providers in Tucker, GA · Skilled Nursing Facility in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.