NPIMap

Organization Active NPI

Parmly on the Lake LLC

  • Skilled Nursing Facility
  • Chisago City, MN
National Provider Identifier
1508370412
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PARMLY ON THE LAKE LLC
Practice address
28210 Old Towne Rd
Chisago City, MN 55013-9556
Phone
(651) 257-0575
NPI assigned
Nov 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Authorized official

Name
Mr. Josh Legum
Title
Ceo
Phone
(507) 697-5674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

28210 Old Towne Rd
Chisago City, MN 55013-9556

Mailing address

638 Southbend Ave
Mankato, MN 56001-2168

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171215002600 MN Part A Provider - Skilled Nursing Facility 3476811670 Practice locations: Chisago City, MN

Skilled nursing facility certification: CCN 245328

Legal name
PARMLY ON THE LAKE LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1986
Last certification
Sep 19, 2024
Beds
91
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Monarch Healthcare Management
Organization structure
LLCProprietary
Incorporated
Nov 2, 2017 in MN
Enrollment address
28210 Old Towne Rd
Chisago City, MN 55013-9556
Nursing home name
PARMLY ON THE LAKE LLC
Affiliated entity
MONARCH HEALTHCARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Parmly on the Lake LLCCCN 245328
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9183.4 residents per day on average
Chain
Monarch Healthcare Management45 facilities in the chain
Penalties (3 years)
1Fines totaling $8,193

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Monarch Healthcare Operating V LLC Organization, Mankato, MN LLC, For-profit Operational/Managerial Control Dec 29, 2017 100%
Spartan Healthcare LLC Organization, Chicago, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 29, 2017 28%
WBS Holdings LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 29, 2017 19%
William Stern Individual 5% Or Greater Indirect Ownership Interest Dec 29, 2017 19%
Corporate OfficerChief Financial Officer Dec 29, 2017 19%
Marc Halpert Individual 5% Or Greater Indirect Ownership Interest Dec 29, 2017 28%
Corporate OfficerChief Operations Officer Dec 29, 2017 28%
Jeffrey Arem Individual 5% Or Greater Indirect Ownership Interest Dec 29, 2017 15%
Joshua Legum Individual Contracted Managing EmployeeCeo Dec 29, 2017 28%
5% Or Greater Indirect Ownership Interest Dec 29, 2017 28%
Yazoma Holdings, LLC Organization, Skokie, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 29, 2017 28%
Noam Jaffa Individual 5% Or Greater Indirect Ownership Interest Dec 29, 2017 10%
Corporate DirectorDirector of Procurement Dec 29, 2017 10%
Nij LLC Organization, St Louis Park, MN LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 29, 2017 10%
Jca Holdings LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 29, 2017 15%

Facilities with the same owner 44

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

View all 44

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1508370412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 SOUTHBEND AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560012168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28210 OLD TOWNE RD",
            "city": "CHISAGO CITY",
            "state": "MN",
            "postal_code": "550139556",
            "telephone_number": "651-257-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARMLY ON THE LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-697-5674",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chisago City, MN

Sources for this page

Verify at the official NPI Registry.