The Green Prairie Rehabilitation Center LLC
Organization Active NPI Skilled Nursing Facility · Plainview, MN
NPI 1659728186 · NPPES record last updated May 13, 2016
Key facts
- NPI
- 1659728186
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- THE GREEN PRAIRIE REHABILITATION CENTER LLC
- Practice address
- 810 2ND Ave NW
Plainview, MN 55964-1090 - Phone
- (507) 534-4204
- NPI assigned
- May 13, 2016
- Organization subpart
- No
Authorized official
- Name
- Josh Legum
- Title
- Member
- Phone
- (507) 625-8741
Facilities with the same owner 44
Practitioners 2
-
Kyle M McKenzie, MD
Affiliated clinicians 2
-
Kyle M McKenzie, MD
Medicare Care Compare: Nursing home
- Listed as
- The Green Prairie Rehabilitation Center
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 1, 1986
- Medicare certification status
- Active
- Certified beds
- 42 · 38.6 residents per day on average
- Chain
- Monarch Healthcare Management
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0404565 | The Green Prairie Rehabilitation Center | Certificate of waiver | Jun 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245345
- Legal name
- THE GREEN PRAIRIE REHABILITATION CENTER LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 1, 1986
- Last certification
- Oct 31, 2024
- Beds
- 42
- Ownership / control type
- Corporation
- Multi-facility organization
- Monarch Healthcare Management
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 22, 2016 in MN
- Enrollment address
- 800 2ND Ave NW
Plainview, MN 55964-1041 - Nursing home name
- THE GREEN PRAIRIE REHABILITATION CENTER
- Affiliated entity
- MONARCH HEALTHCARE MANAGEMENT
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey Muencz |
5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 12% |
| Spartan Healthcare LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 22.5% |
| William Stern |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 15% |
| Corporate Officer |
Jul 1, 2016 | 15% | |
| Marc Halpert |
5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 22.5% |
| Corporate Director |
Jul 1, 2016 | 22.5% | |
| Jeffrey Arem |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 14.25% |
| HML LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 12% |
| Monarch Healthcare Operating IV LLC |
Operational/Managerial Control | Jul 1, 2016 | 100% |
| Joshua Legum |
5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 22.5% |
| W-2 Managing Employee |
Jul 1, 2016 | 22.5% | |
| Yazoma Holdings, LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 22.5% |
| Noam Jaffa |
5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 13.75% |
| Nij LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 13.75% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160518001911 | MN | Part a Provider - Skilled Nursing Facility | 0941599773 | Practice locations: Plainview, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
810 2ND Ave NW
Plainview, MN 55964-1090
Mailing address
638 Southbend Ave
Mankato, MN 56001-2168
Other providers in Plainview, MN
- Amanda Stradtmann
- James Leo Stucky
- Judd A Stucky
- Windy Lynn Taylor
- The Green Prairie Assisted Living LLC
- Clarissa Thomson
- Virtual Healthcare LLC
- Cassidy Vlieger
- James Alfred Walz
- Christopher Scott Woodcock
All providers in Plainview, MN · Skilled Nursing Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.