Active NPI
Snowshoe LTC Group, LLC
Doing business as Greenhaven Health and Rehabilitation Center
- Skilled Nursing Facility
- Greensboro, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH0368
- Legal business name
- SNOWSHOE LTC GROUP, LLC
- Doing business as
- Greenhaven Health and Rehabilitation Center
- Practice address
- 801 Greenhaven Dr
Greensboro, NC 27406-7103 - Phone
- (336) 292-8371
- Fax
- (336) 299-8414
- NPI assigned
- Jul 5, 2006
- Last updated
- Jul 9, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gale Boice
- Title
- Cfo
- Phone
- (252) 523-9094
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH0368 | NC | Primary |
Addresses
Primary practice location
801 Greenhaven Dr
Greensboro, NC 27406-7103
Mailing address
801 Greenhaven Dr
Greensboro, NC 27406-7103
Phone (336) 292-8371
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3425132 | Medicaid | NC | |
| 26711 | Other | NC | PARTNERS INSURANCE |
| 3435132 | Medicaid | NC | |
| 00870 | Other | NC | BC/BS OF NC |
| 3416303 | Medicaid | NC | |
| 7108249 | Other | NC | UNITED HEALTHCARE |
Other names 1
- Greenhaven Health and Rehabilitation Center
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110411000479 | NC | Part A Provider - Skilled Nursing Facility | 5092996207 | Practice locations: Greensboro, NC |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1619908977. Details of each certification follow.
Skilled nursing facility certification: CCN 345132
- Legal name
- SNOWSHOE LTC GROUP, LLC
- Doing business as
- GREENHAVEN HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 1, 1974
- Last certification
- Mar 14, 2024
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Principle LTC
- Organization structure
- LLC
- Incorporated
- Aug 16, 2010 in NC
- Enrollment address
- 801 Greenhaven Dr
Greensboro, NC 27406-7103 - Nursing home name
- GREENHAVEN HEALTH AND REHABILITATION CENTER
- Affiliated entity
- PRINCIPLE LONG TERM CARE
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Maple Grove Health and Rehabilitation Center
- Skilled Nursing Facility
- Greensboro, NC
- NPI 1326074048
5092996207
-
dba Piney Grove Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Kernersville, NC
- NPI 1811923931
5092996207
-
dba Smoky Mountain Health and Rehabilitation Center
- Skilled Nursing Facility
- Waynesville, NC
- NPI 1861504946
5092996207
-
dba Wayland Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Keysville, VA
- NPI 1265463566
5092996207
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Greenhaven Health and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Aug 1, 1974
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Principle Long Term Care
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0723577 | Snowshoe LTC, LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Ability Network
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Maple Grove Health and Rehabilitation Center
- Adult Care Home Facility
- Greensboro, NC
- NPI 1144405804
-
dba Maple Grove Health and Rehabilitation Center
- Skilled Nursing Facility
- Greensboro, NC
- NPI 1326074048
-
dba Smoky Mountain Health and Rehabilitation Center
- Skilled Nursing Facility
- Waynesville, NC
- NPI 1861504946
-
dba Wayland Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Keysville, VA
- NPI 1265463566
Ownership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Raymond Gregg Hill | 5% Or Greater Indirect Ownership Interest | Jan 1, 2011 | 18.47% |
| Robert O'Neil Hill | 5% Or Greater Indirect Ownership Interest | Jan 1, 2011 | 20.6% |
| Stephen Britt Hill | 5% Or Greater Indirect Ownership Interest | Jan 1, 2011 | 20.02% |
| Gale R Boice | Corporate Officer | Mar 5, 2018 | |
| Dianne Johnson | Corporate Officer | Jan 1, 2011 | |
| Principle Long Term Care, Inc. | 5% Or Greater Direct Ownership Interest | Jan 1, 2011 | 50% |
| Operational/Managerial Control | Jan 1, 2011 | ||
| Khashana a Blake | Managing Control - Governing Body | Jan 1, 2025 | |
| Adp of the SNF | May 12, 2025 | ||
| Malik Simpson | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | May 12, 2025 | ||
| Principle It Services, Inc. | 5% Or Greater Direct Ownership Interest | Jan 1, 2011 | 50% |
| Anthony Abela | Operational/Managerial Control | Nov 1, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Winston Salem, NC
- NPI 1356543490
Adp of the SNF, Managing Control - Governing Body
Facilities with the same owner 43
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Barbour Court Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Smithfield, NC
- NPI 1225064777
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Willow Creek Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Goldsboro, NC
- NPI 1508802497
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Continuum II Home Care & Hospice of Pender County
- Community Based Hospice Care Agency
- Hampstead, NC
- NPI 1457648909
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Continuum Home Care & Hospice of Lenoir
- Community Based Hospice Care Agency
- Kinston, NC
- NPI 1619074937
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Westwood Hills Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Wilkesboro, NC
- NPI 1184650541
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Franklin Oaks Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Louisburg, NC
- NPI 1376570275
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Kerr Lake Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Henderson, NC
- NPI 1972547321
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Springbrook Nursing and Rehabilitation
- Skilled Nursing Facility
- Clayton, NC
- NPI 1003205337
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Tower Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Raleigh, NC
- NPI 1356387153
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba LAKE PARK Nursing & Rehabilitation Center
- Skilled Nursing Facility
- Indian Trail, NC
- NPI 1548206907
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Jacob's Creek Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Madison, NC
- NPI 1255367447
Principle It Services, Inc., Principle Long Term Care, Inc.
-
dba Graham Healthcare and Rehabilitation Center
- Skilled Nursing Facility
- Robbinsville, NC
- NPI 1366487464
Principle It Services, Inc., Principle Long Term Care, Inc.
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1152057600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1625788800000",
"number": "1619908977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 GREENHAVEN DR",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274067103",
"telephone_number": "336-292-8371",
"fax_number": "336-299-8414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 GREENHAVEN DR",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274067103",
"telephone_number": "336-292-8371",
"fax_number": "336-299-8414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SNOWSHOE LTC GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-05",
"last_updated": "2021-07-09",
"certification_date": "2021-07-09",
"status": "A",
"authorized_official_last_name": "BOICE",
"authorized_official_first_name": "GALE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "252-523-9094"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NC",
"license": "NH0368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3425132",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS INSURANCE",
"identifier": "26711",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3435132",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF NC",
"identifier": "00870",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3416303",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "7108249",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Greenhaven Health and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Greenhaven Health and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.