NPIMap

Organization Active NPI

Complete Care at Milford Manor LLC

  • Skilled Nursing Facility
  • West Milford, NJ
National Provider Identifier
1659030765
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMPLETE CARE AT MILFORD MANOR LLC
Practice address
69 Maple Rd
West Milford, NJ 07480-2707
Phone
(973) 697-5640
NPI assigned
Dec 16, 2021
Last updated
May 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Authorized official

Name
Shalom Stein
Title
Ceo
Phone
(732) 313-0880

Specialties & licenses 1

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

Addresses

Primary practice location

69 Maple Rd
West Milford, NJ 07480-2707

Mailing address

69 Maple Rd
West Milford, NJ 07480-2707

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220224002557 NJ Part A Provider - Skilled Nursing Facility 2668866286 Practice locations: West Milford, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659030765. Details of each certification follow.

Skilled nursing facility certification: CCN 315276

Legal name
COMPLETE CARE AT MILFORD MANOR LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1989
Last certification
Mar 7, 2025
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Complete Care Management
Most recent change of ownership
Dec 27, 2021
Organization structure
LLCProprietary
Enrollment address
69 Maple Rd
West Milford, NJ 07480-2707
Nursing home name
COMPLETE CARE AT MILFORD MANOR LLC
Affiliated entity
COMPLETE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Complete Care at Milford Manor LLCCCN 315276 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120111.7 residents per day on average
Chain
Complete Care85 facilities in the chain
Penalties (3 years)
1Fines totaling $3,595

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
31D0877294Milford Manor69 Maple Road, West Milford, NJ 07480Certificate of waiverSep 29, 2027

National Provider Directory

National Provider Directory

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.

NameRoleSinceShare
Emmanuel a Aydin Individual Operational/Managerial Control Dec 27, 2021
Adp of the SNF Dec 27, 2021
Peace Capital Holdings LLC Organization, Howell, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 27, 2021 100%
Adp of the SNF Dec 27, 2021
Milford Manor Propco LLC Organization, Toms River, NJ LLC, Holding company, For-profit Adp of the SNF Dec 27, 2021
Raanan Zackai Individual Operational/Managerial Control Dec 27, 2021
Milford Manor Holdco LLC Organization, Toms River, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 27, 2021 100%
Adp of the SNF Dec 27, 2021
SMS 2021 Trust Organization, Lakewood, NJ For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 27, 2021 95.1%
Adp of the SNF Dec 27, 2021
PC GC Holdco LLC Organization, Toms River, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 27, 2021 100%
Adp of the SNF Dec 27, 2021
Grace Reyes Individual Operational/Managerial Control Mar 13, 2023
Adp of the SNF Mar 13, 2023
Shalom Stein Individual Corporate Officer Dec 27, 2021
Managing Control - Governing Body Dec 27, 2021
Trustee of the SNF Dec 27, 2021
Indirect Ownership Interest Dec 27, 2021 4.9%
Rizza R. Ruaya Individual Adp of the SNF Apr 8, 2025

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 66

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

View all 66

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 4

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": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1659030765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 MAPLE RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074802707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 MAPLE RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074802707",
            "telephone_number": "973-697-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE AT MILFORD MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-313-0880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Milford, NJ

Sources for this page

Verify at the official NPI Registry.