NPIMap

Organization Active NPI

River Valley Rehabilitation and Healthcare Center LLC

  • Skilled Nursing Facility
  • Del Norte, CO
National Provider Identifier
1659008399
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RIVER VALLEY REHABILITATION AND HEALTHCARE CENTER LLC
Practice address
1335 6TH St
Del Norte, CO 81132-3201
Phone
(719) 657-1105
NPI assigned
Aug 3, 2022
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Ralph Gottlieb
Title
Manager of the Manager
Phone
(719) 657-1105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1335 6TH St
Del Norte, CO 81132-3201

Mailing address

575 Route 70 FL 2
Brick, NJ 08723-4042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221006001407 CO Part A Provider - Skilled Nursing Facility 1254717713 Practice locations: Del Norte, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659008399. Details of each certification follow.

Skilled nursing facility certification: CCN 065424

Legal name
RIVER VALLEY REHABILITATION AND HEALTHCARE CENTER LLC
Doing business as
RIVER VALLEY REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 16, 2017
Last certification
Dec 19, 2024
Beds
60
Ownership / control type
Individual
Most recent change of ownership
Sep 1, 2022
Organization structure
LLCProprietary
Enrollment address
1335 6TH St
Del Norte, CO 81132-3201
Nursing home name
RIVER VALLEY REHABILITATION AND HEALTHCARE CENTER
Affiliated entity
CENTENNIAL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
River Valley Rehabilitation and Healthcare CenterCCN 065424 · All quality measures
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 - Individual
Certified
Aug 16, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6057.2 residents per day on average
Chain
Centennial Healthcare8 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
River Valley Rehab and Healthcare Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 30

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

NameRoleSinceShare
Individual Indirect Ownership Interest Sep 1, 2022 0.5%
Kelsey J Walker Individual Operational/Managerial Control May 1, 2024
Adp of the SNF Sep 30, 2025
Organization, Toms River, NJ LLC Adp of the SNF Sep 1, 2022
Individual Trustee of the SNF Sep 1, 2022
Indirect Ownership Interest Sep 1, 2022 1%
Centennial III Colorado Holdco LLC Organization, Brick, NJ LLC 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Centennial I TBD Holdco LLC Organization, Brick, NJ 5% Or Greater Indirect Ownership Interest Sep 1, 2022 100%
Individual Trustee of the SNF Sep 1, 2022
Bank Hapoalim B.M. Organization, New York, NY Corporation, Owned by another organization or individual 5% Or Greater Mortgage Interest Apr 30, 2025
Operational/Managerial Control Apr 30, 2025
Refoel Gottlieb Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2022 20%
Operational/Managerial Control Sep 1, 2022
Managing Control - Governing BodyManager of the Manager Sep 1, 2022
Adp of the SNF Sep 1, 2022
Emssah Non- Grantor Trust Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest Sep 1, 2022 9.51%
Individual Trustee of the SNF Sep 1, 2022
Organization, Toms River, NJ LLC Adp of the SNF Sep 1, 2022
Individual Indirect Ownership Interest Sep 1, 2022 1%
Individual Indirect Ownership Interest Sep 1, 2022 2%
Centennial MN TR I Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Jan 1, 2025 7%
Organization, Toms River, NJ LLC Adp of the SNF Sep 2, 2022
Individual Indirect Ownership Interest Sep 1, 2022 1%
Individual Trustee of the SNF Sep 1, 2022
Individual Indirect Ownership Interest Sep 1, 2022 0.75%
Individual Trustee of the SNF Sep 1, 2022
Centennial Yf Trust I Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 1, 2022 17.73%
Centennial M Trust II Organization, Toms River, NJ 5% Or Greater Indirect Ownership Interest Jan 1, 2025 7%
Centennial Ms Trust I Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 1, 2022 17.74%
Crystal Klippert Individual Operational/Managerial Control Jun 17, 2024
Adp of the SNF Sep 30, 2025
Individual Indirect Ownership Interest Sep 1, 2022 0.75%
Individual Trustee of the SNF Sep 1, 2022
Individual Trustee of the SNF Sep 1, 2022
Organization, Toms River, NJ Adp of the SNF Sep 1, 2022
Individual Trustee of the SNF Sep 1, 2022
Individual Trustee of the SNF Sep 1, 2022
Adp of the SNF Sep 1, 2022

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 7

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1659008399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROUTE 70 FL 2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 6TH ST",
            "city": "DEL NORTE",
            "state": "CO",
            "postal_code": "811323201",
            "telephone_number": "719-657-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER VALLEY REHABILITATION AND HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "MANAGER OF THE MANAGER",
        "authorized_official_telephone_number": "719-657-1105"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Norte, CO

Sources for this page

Verify at the official NPI Registry.