Ridgecrest Manor Nursing and Rehabilitation, LLC
Organization Active NPI Skilled Nursing Facility · Duffield, VA
NPI 1679981930 · NPPES record last updated Jan 14, 2022
Key facts
- NPI
- 1679981930
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- RIDGECREST MANOR NURSING AND REHABILITATION, LLC
- Practice address
- 157 Ross Carter Blvd
Duffield, VA 24244-5116 - Phone
- (276) 431-2841
- Fax
- (276) 431-4718
- NPI assigned
- Jul 30, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- SABER HEALTHCARE HOLDINGS, LLC
Authorized official
- Name
- William I Weisberg
- Title
- President
- Phone
- (216) 292-5706
Facilities with the same owner 122
Affiliated clinicians 2
-
Andrew Lenox Barlow, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Ridgecrest Manor Nursing & Rehabilitation
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Nov 24, 1982
- Medicare certification status
- Active
- Certified beds
- 120 · 104.9 residents per day on average
- Chain
- Saber Healthcare Group
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Skilled nursing facility certification: CCN 495134
- Legal name
- RIDGECREST MANOR NURSING AND REHABILITATION, LLC
- Doing business as
- RIDGECREST MANOR NURSING AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 24, 1982
- Last certification
- Feb 22, 2024
- Beds
- 120
- Ownership / control type
- Corporation
- Multi-facility organization
- Saber Healthcare
- Most recent change of ownership
- Nov 1, 2014
- Organization structure
- LLC · Proprietary
- Incorporated
- Jun 23, 2014 in VA
- Enrollment address
- 157 Ross Carter Blvd
Duffield, VA 24244-5116 - Nursing home name
- RIDGECREST MANOR NURSING & REHABILITATION
- Affiliated entity
- SABER HEALTHCARE GROUP
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Saber Healthcare Holdings LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2014 | 100% |
| WWBV Holdings LLC |
5% Or Greater Indirect Ownership Interest | Sep 30, 2019 | 100% |
| Steven Daniel Jones |
W-2 Managing Employee |
Aug 1, 2022 | 100% |
| Benjamin N. Volpe Family Dynasty Trust (Dated December 29, 2020) |
5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 22.22% |
| Gregory Nicoluzakis |
Corporate Officer |
Mar 1, 2019 | |
| SHG Management LLC |
Operational/Managerial Control | Sep 1, 2019 | |
| Saber Governance LLC |
Operational/Managerial Control | Sep 1, 2019 | 100% |
| Saber Healthcare Group LLC |
Other | Nov 1, 2014 | |
| BNV Dynasty LLC |
5% Or Greater Indirect Ownership Interest | Dec 31, 2020 | 22.22% |
| Benjamin N Volpe |
Corporate Officer |
Mar 1, 2019 | |
| Corporate Director |
Mar 1, 2019 | 50% | |
| Wiw Dynasty LLC |
5% Or Greater Indirect Ownership Interest | Sep 30, 2019 | 77.78% |
| William I Weisberg |
Corporate Officer |
Mar 1, 2019 | |
| Corporate Director |
Mar 1, 2019 | 50% | |
| Mitchell P Davis |
Operational/Managerial Control |
Jun 4, 2018 | |
| SHH Holdings LLC |
5% Or Greater Indirect Ownership Interest | Mar 1, 2019 | 100% |
| Decanted William I. Weisberg Family Dynasty Trust (Dated Sept 30, 2020 |
5% Or Greater Indirect Ownership Interest | Sep 30, 2020 | 77.78% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141113002119 | VA | Part a Provider - Skilled Nursing Facility | 5799907325 | Practice locations: Duffield, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
157 Ross Carter Blvd
Duffield, VA 24244-5116
Mailing address
23700 Commerce Park
Beachwood, OH 44122-5827
Phone (216) 292-5706
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679981930 | Medicaid | VA |
Other providers in Duffield, VA
- Shonna Peterson
- Kathy Phillips
- Regional Health Resources Inc
- Regional Health Resources, Inc
- Kristi Richardson
- Saber Ridgecrest Manor
- Saborah Lee Salvatore
- Lauren Elizabeth Setler
- Julia Eve Shubert
- Johnny R Shupe
All providers in Duffield, VA · Skilled Nursing Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2022. 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.