Glen Brook Rehabilitation and Healthcare Center LLC
Organization Active NPI Skilled Nursing Facility · Berwick, PA
NPI 1609548858 · NPPES record last updated Nov 30, 2021
Key facts
- NPI
- 1609548858
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- GLEN BROOK REHABILITATION AND HEALTHCARE CENTER LLC
- Practice address
- 801 E 16TH St
Berwick, PA 18603-2314 - Phone
- (570) 802-9060
- Fax
- (570) 802-9023
- NPI assigned
- Oct 5, 2021
- Organization subpart
- No
Authorized official
- Name
- Moshe A Stern
- Title
- Authorized Member
- Phone
- (848) 249-7952
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Affiliated clinicians 3
-
Gary Douglas Kanouse, M.D.
-
Pavel Pribula, M.D.
-
Dennis M. Sheehe, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Glen Brook Rehabilitation and Healthcare Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 25, 1978
- Medicare certification status
- Active
- Certified beds
- 240 · 197.8 residents per day on average
- Chain
- Prestige Healthcare Administrative Services
- Penalties (3 years)
- 2 · fines totaling $260,715
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Skilled nursing facility certification: CCN 395421
- Legal name
- GLEN BROOK REHABILITATION AND HEALTHCARE CENTER LLC
- Doing business as
- GLEN BROOK REHABILITATION AND HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 25, 1978
- Last certification
- Mar 21, 2025
- Beds
- 240
- Ownership / control type
- Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 4, 2021 in PA
- Enrollment address
- 801 E 16TH St
Berwick, PA 18603-2314 - Nursing home name
- GLEN BROOK REHABILITATION AND HEALTHCARE CENTER
- Affiliated entity
- PRESTIGE HEALTHCARE ADMINISTRATIVE SERVICES
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Moshe a Stern |
5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 98% |
| Corporate Officer | Nov 1, 2021 | ||
| GBRH Holdco LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2021 | 100% |
| Susan P Matelevich |
Operational/Managerial Control | Nov 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211130003199 | PA | Part a Provider - Skilled Nursing Facility | 4587054804 |
1 other NPI on this enrollment Practice locations: Berwick, PA |
National Provider Directory
- Tax ID family
- Glen Brook Rehabilitation and Healthcare Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
801 E 16TH St
Berwick, PA 18603-2314
Mailing address
801 E 16TH St
Berwick, PA 18603-2314
Phone (570) 802-9060
Other names
- Glen Brook Rehabilitation and Healthcare Center
Other providers in Berwick, PA
- Geisinger Clinic
- Geisinger Clinic
- Anton Lyubomirov Georgiev
- Frank J Giugliano
- Glen Brook Rehabilitation and Healthcare Center LLC
- Lauren L Gromel
- Elizabeth Gromelski
- Grace Guerrier
- John Anthony Guerriero III
- John Hall Jr.
All providers in Berwick, PA · Skilled Nursing Facility in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2021. 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.