NPIMap

Organization Active NPI

Loma Linda SNF Healthcare, LLC

Doing business as Loma Linda Post Acute

  • Skilled Nursing Facility
  • Loma Linda, CA
National Provider Identifier
1649968900
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LOMA LINDA SNF HEALTHCARE, LLC
Doing business as
Loma Linda Post Acute
Practice address
25383 Cole St
Loma Linda, CA 92354-3103
Phone
(909) 796-0235
NPI assigned
Apr 25, 2023
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

25383 Cole St
Loma Linda, CA 92354-3103

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Loma Linda Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240224000268 CA Part A Provider - Skilled Nursing Facility 7113362682 Practice locations: Loma Linda, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649968900. Details of each certification follow.

Skilled nursing facility certification: CCN 055299

Legal name
LOMA LINDA SNF HEALTHCARE LLC
Doing business as
LOMA LINDA POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Jun 20, 2024
Beds
83
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
May 24, 2023 in CA
Enrollment address
25383 Cole St
Loma Linda, CA 92354-3103
Nursing home name
LOMA LINDA POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Loma Linda Post AcuteCCN 055299 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8378.4 residents per day on average
Chain
Pacs Group274 facilities in the chain

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
05D2299567Loma Linda Post Acute25383 Cole Street, Loma Linda, CA 92354Certificate of waiverFeb 21, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Organization, North Hollywood, CA LLC, For-profit Adp of the SNF Jun 30, 2023
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Jun 29, 2023 50%
John T Mitchell Individual Operational/Managerial Control Jan 1, 2024
Kenneth Jardine Individual Operational/Managerial Control Mar 1, 2024
Adp of the SNF Apr 2, 2025
Joel Dimaunahan Individual Operational/Managerial Control Sep 9, 2024
Trevor D. Lords Individual Operational/Managerial Control Jun 29, 2023
Adp of the SNF Apr 23, 2025
Frederick G Apt Individual Operational/Managerial Control Jan 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Providence Administrative Consulting Services Inc Organization, Farmington, UT Corporation, Consulting firm, For-profit Adp of the SNF Jun 30, 2023
Truist Bank Organization, Charlotte, NC Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Dec 7, 2023 100%
Joshua O Jergensen Individual Operational/Managerial Control Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 29, 2023 100%
Shantharam Pai Individual Operational/Managerial Control Jul 1, 2023
Adp of the SNF Apr 2, 2025
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Jun 29, 2023 50%
Loma Linda Master Tenant LLC Organization, Farmington, UT LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 24, 2023 100%

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 186

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

View all 186

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": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1649968900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25383 COLE ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543103",
            "telephone_number": "909-796-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA SNF HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loma Linda Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Loma Linda Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.