NPIMap

Organization Active NPI

Clovernook Healthcare LLC

  • Skilled Nursing Facility
  • Cincinnati, OH
National Provider Identifier
1508340571
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CLOVERNOOK HEALTHCARE LLC
Practice address
7025 Clovernook Ave
Cincinnati, OH 45231-5557
Phone
(513) 605-4000
Fax
(513) 522-4122
NPI assigned
Sep 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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

Authorized official

Name
Jacob Stern
Title
Sole Member
Phone
(734) 659-1353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

7025 Clovernook Ave
Cincinnati, OH 45231-5557

Mailing address

15 America Ave Unit 304
Lakewood, NJ 08701-4582
Phone (732) 659-1353

Other identifiers 1

IdentifierTypeStateIssuer
1743NOtherOHLICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181121000065 OH Part A Provider - Skilled Nursing Facility 9931453354 Practice locations: Cincinnati, OH

Skilled nursing facility certification: CCN 365551

Legal name
CLOVERNOOK HEALTHCARE LLC
Doing business as
CLOVERNOOK HEALTHCARE AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 18, 1981
Last certification
Oct 25, 2024
Beds
126
Ownership / control type
Corporation
Multi-facility organization
CCH
Organization structure
LLCProprietary
Incorporated
Aug 21, 2018 in OH
Enrollment address
7025 Clovernook Ave
Cincinnati, OH 45231-5557
Nursing home name
CLOVERNOOK HEALTH CARE AND REHABILITATION CENTER
Affiliated entity
CCH HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Clovernook Health Care and Rehabilitation CenterCCN 365551
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
Mar 18, 1981
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
126107.8 residents per day on average
Chain
CCH Healthcare33 facilities in the chain

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
36D0347069Clovernook Healthcare LLC7025 Clovernook Ave, Cincinnati, OH 45231Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Clovernook Healthcare Holdings LLC Organization, Lakewood, NJ Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Aug 21, 2018 100%
CH Clovernook Holdings LLC Organization, Lakewood, NJ Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Aug 21, 2018 46.31%
Starlight Healthcare LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest Aug 21, 2018 47.51%
Deborah Bisel Individual W-2 Managing EmployeeAdministrator Aug 21, 2018 100%
Jacob Stern Individual 5% Or Greater Indirect Ownership InterestManaging Member Aug 21, 2018 5%
Corporate OfficerPresident and Treasurer Aug 21, 2018 100%
Corporate DirectorChairman of the Board Aug 21, 2018 100%

Facilities with the same owner 26

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

View all 26

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 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": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1508340571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 AMERICA AVE UNIT 304",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014582",
            "telephone_number": "732-659-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 CLOVERNOOK AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452315557",
            "telephone_number": "513-605-4000",
            "fax_number": "513-522-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERNOOK HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "734-659-1353"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "1743N",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.