Holden Manor Health & Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HOLDEN MANOR HEALTH & REHABILITATION LLC

Practice address

2005 S Lexington St
Holden, MO 64040-1610

Phone

(816) 732-4138

Fax

(816) 324-4097

NPI assigned

Jul 5, 2023

Organization subpart

No

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

Authorized official

Name

Chaim Mandelbaum

Title

Manager

Phone

(816) 732-4138

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Skilled nursing facility certification: CCN 265739

Legal name

HOLDEN MANOR HEALTH & REHABILITATION LLC

Doing business as

HOLDEN MANOR HEALTH & REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 14, 2002

Last certification

Aug 2, 2024

Beds

52

Ownership / control type

Corporation

Most recent change of ownership

Jul 1, 2023

Organization structure

LLCProprietary

Enrollment address

2005 S Lexington St
Holden, MO 64040-1610

Nursing home name

HOLDEN MANOR HEALTH & REHABILITATION

Affiliated entity

MO OP HOLDCO, LLC

All disclosed owners & managing parties 35

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

Locations

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

• Steven Michael Cicero, D.O.

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1407211873

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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

• Laverna Manor Health & Rehabilitation LLC

  • Skilled Nursing Facility
  • Savannah, MO
  • NPI 1417635046

  Mo Op Holdco, LLC

  CMS ownership
• Parkdale Manor Health & Rehabilitation LLC

  • Skilled Nursing Facility
  • Maryville, MO
  • NPI 1962180596

  Mo Op Holdco, LLC

  CMS ownership
• St. Joseph Manor Health & Rehabilitation LLC

  • Skilled Nursing Facility
  • Saint Joseph, MO
  • NPI 1689352213

  Mo Op Holdco, LLC

  CMS ownership

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

• Syed P Hasan, M.D.

  • Internal Medicine Physician
  • Warrensburg, MO
  • NPI 1861418121
  NPD (past)

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Syed P Hasan, M.D.

  • Internal Medicine Physician
  • Warrensburg, MO
  • NPI 1861418121

  Nursing home

  Care Compare affiliation

Listed as

Holden Manor Health & RehabilitationCCN 265739

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 - Corporation

Certified

May 14, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5235.2 residents per day on average

Chain

Mo Op Holdco, LLC9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1619655248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 S LEXINGTON ST",
            "city": "HOLDEN",
            "state": "MO",
            "postal_code": "640401610",
            "telephone_number": "816-732-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 S LEXINGTON ST",
            "city": "HOLDEN",
            "state": "MO",
            "postal_code": "640401610",
            "telephone_number": "816-732-4138",
            "fax_number": "816-324-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDEN MANOR HEALTH & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "MANDELBAUM",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "816-732-4138"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lee Gilcrest, OTR/L
• Heart in Hands LLC
• Mary Marie Hoenshell, OTA/L
• Holden Family Care, LLC
• Holden Family Care, LLC
• Holden Manor, Inc.
• Holden Public School District R-III
• Holly Nicole Hoover, LPN
• Teri N Hughes, PTA
• Veronica Immethun, MS, CCC-SLP

• All providers in Holden, MO
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.