NPIMap

Organization Active NPI

Fresno Nursing and Rehab Center LLC

Doing business as Fresno Nursing Center

  • Skilled Nursing Facility
  • Fresno, CA
National Provider Identifier
1528625811
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FRESNO NURSING AND REHAB CENTER LLC
Doing business as
Fresno Nursing Center
Practice address
3672 N 1St St
Fresno, CA 93726-6810
Phone
(801) 601-1450
NPI assigned
May 22, 2019
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Brooke Hixson
Title
Controller
Phone
(801) 601-1450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3672 N 1St St
Fresno, CA 93726-6810

Mailing address

1376 E 3300 S
Salt Lake City, UT 84106-3069
Phone (801) 601-1450

Other names 1

  • Fresno Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190906001565 CA Part A Provider - Skilled Nursing Facility 8123357704 Practice locations: Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528625811. Details of each certification follow.

Skilled nursing facility certification: CCN 056266

Legal name
FRESNO NURSING AND REHAB CENTER LLC
Doing business as
FRESNO NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 25, 1971
Last certification
Apr 26, 2024
Beds
65
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Jericho Care Group
Organization structure
LLCProprietary
Incorporated
Apr 29, 2019 in CA
Enrollment address
3672 N 1St St
Fresno, CA 93726-6810
Nursing home name
KEYSTONE POST-ACUTE
Affiliated entity
EDURO HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Keystone Post-AcuteCCN 056266 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 25, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6560.7 residents per day on average
Chain
Eduro Healthcare34 facilities in the chain
Penalties (3 years)
2Fines totaling $42,764

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

3672 N 1st St
Fresno, CA 93726
Phone (559) 227-5383

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
Michael C Bewsey Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2019 100%
Corporate OfficerManaging Director Jun 1, 2019 100%
Braeden Carter Individual W-2 Managing EmployeeAd; Feb 1, 2024
Dustin Monroe Individual Corporate OfficerSecretary Jul 19, 2022
Eduro Healthcare LLC Organization, Salt Lake City, UT LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2019 100%
Fresno Nursing and Rehab Center LLC Organization, Salt Lake City, UT LLC, For-profit 5% Or Greater Direct Ownership Interest Jun 1, 2019 100%
Operational/Managerial Control Jun 1, 2019 100%

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1528625811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063069",
            "telephone_number": "801-601-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3672 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266810",
            "telephone_number": "801-601-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO NURSING AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "HIXSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "801-601-1450"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresno Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.