NPIMap

Organization Active NPI

Sela Healthcare Inc

Doing business as Villa Mesa Care Center

  • Skilled Nursing Facility
  • Upland, CA
National Provider Identifier
1588770929
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
240000203 Issued in CA
Legal business name
SELA HEALTHCARE INC
Doing business as
Villa Mesa Care Center
Practice address
867 E 11TH St
Upland, CA 91786-4867
Phone
(909) 985-1981
Fax
(909) 982-2885
NPI assigned
Aug 21, 2006
Last updated
Aug 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Ms. Jennifer Greenwell
Title
Chief Financial Officer
Phone
(909) 987-7735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 240000203 CA Primary

Addresses

Primary practice location

867 E 11TH St
Upland, CA 91786-4867

Mailing address

16742 Orange Way
Fontana, CA 92335-3809
Phone (909) 987-7735

Other identifiers 1

IdentifierTypeStateIssuer
ZZT06136IMedicaidCA

Other names 1

  • Villa Mesa Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000436 CA Part A Provider - Skilled Nursing Facility 9638082092 Practice locations: Upland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588770929. Details of each certification follow.

Skilled nursing facility certification: CCN 056136

Legal name
SELA HEALTHCARE INC
Doing business as
VILLA MESA CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1972
Last certification
Oct 3, 2024
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
CorporationProprietary
Enrollment address
867 E 11TH St
Upland, CA 91786-4867
Nursing home name
VILLA MESA CARE CENTER

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Villa Mesa Care CenterCCN 056136 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 1, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
99103.6 residents per day on average

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
05D0564964Villa Mesa Care Center867 East 11TH Street, Upland, CA 91786Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Holiday Manor Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

867 E 11th St
Upland, CA 91786
Phone (909) 227-0750

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
Abid a Rizvi Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Daniel Grant Individual Operational/Managerial Control Feb 7, 2025
Adp of the SNF Feb 7, 2025
Hadassah E Weiss Individual 5% Or Greater Direct Ownership Interest Aug 17, 2023 20%
Corporate DirectorDirector Aug 17, 2023
Power & Design Development LLC Organization, Rancho Cucamonga, CA LLC, For-profit Adp of the SNF Sep 10, 2025
Renew Health Consulting Services LLC Organization, Monrovia, CA LLC, Management services company, For-profit Operational/Managerial Control Aug 17, 2023
Adp of the SNF Aug 17, 2023
Martin J Weiss Individual 5% Or Greater Direct Ownership Interest Aug 17, 2023 20%
Corporate OfficerPresident Aug 17, 2023
Corporate DirectorDirector Aug 17, 2023
Philip Weinberger Individual 5% Or Greater Direct Ownership Interest Apr 1, 2002 30%
Corporate OfficerChief Executive Officer Aug 17, 2023
Corporate DirectorDirector Nov 11, 2003
Marylynn Mahan Individual 5% Or Greater Direct Ownership Interest Aug 17, 2023 30%
Corporate OfficerSecretary and Treasurer Aug 17, 2023
Corporate DirectorDirector Aug 17, 2023
Vatsala Sharma Individual Operational/Managerial Control Aug 17, 2023
Adp of the SNF Aug 17, 2023
Gateways Rehabilitation Center II LLC Organization, Simi Valley, CA LLC Adp of the SNF Aug 17, 2023
Patric Gharibian Individual Corporate OfficerAdministrator Nov 25, 2024
Operational/Managerial Control Nov 25, 2024
Adp of the SNF Nov 25, 2024

Owners & managing parties with NPI records 1

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

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 9

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1588770929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16742 ORANGE WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353809",
            "telephone_number": "909-987-7735",
            "fax_number": "909-484-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 E 11TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864867",
            "telephone_number": "909-985-1981",
            "fax_number": "909-982-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELA HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "GREENWELL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "909-987-7735",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "240000203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06136I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Mesa Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.