NPIMap

Organization Active NPI

Mission Trails Healthcare LLC

Doing business as Grossmont Post Acute Care

  • Skilled Nursing Facility
  • La Mesa, CA
National Provider Identifier
1689077588
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MISSION TRAILS HEALTHCARE LLC
Doing business as
Grossmont Post Acute Care
Practice address
8787 Center Dr
La Mesa, CA 91942-3034
Phone
(619) 460-4444
Fax
(619) 460-6341
NPI assigned
Oct 6, 2014
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

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

Addresses

Primary practice location

8787 Center Dr
La Mesa, CA 91942-3034

Mailing address

8787 Center Dr
La Mesa, CA 91942-3034
Phone (619) 460-4444

Other names 1

  • Grossmont Post Acute Care Doing business as

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 CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141217002195 CA Part A Provider - Skilled Nursing Facility 4183947401 Practice locations: La Mesa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689077588. Details of each certification follow.

Skilled nursing facility certification: CCN 055632

Legal name
MISSION TRAILS HEALTHCARE LLC
Doing business as
GROSSMONT POST ACUTE CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1974
Last certification
Jul 27, 2023
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Mission Trails Healthcare Inc.
Organization structure
LLCProprietary
Incorporated
Sep 10, 2014 in NV
Enrollment address
5601 Grossmont Center Dr
La Mesa, CA 91942-3074
Nursing home name
GROSSMONT POST ACUTE CARE
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grossmont Post Acute CareCCN 055632 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9090.7 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
1Fines totaling $11,466

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
05D0688580Grossmont Post Acute Care5601 Grossmont Center Dr, La Mesa, CA 91942Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Katherine Oh Individual Operational/Managerial ControlAdministrator Dec 1, 2014
Managing Control - Governing BodyAdministrator Dec 1, 2014
Adp of the SNF Dec 1, 2014
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Jan 30, 2006 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Sep 10, 2014
Adam Willits Individual Corporate OfficerSole Manager Sep 1, 2017
Flagstone Healthcare South LLC Organization, San Juan Capistrano, CA Corporation, LLC 5% Or Greater Direct Ownership Interest Sep 10, 2014 100%
Amir Fahid Individual Operational/Managerial Control May 28, 2019
Managing Control - Governing BodyMedical Director May 28, 2019
Adp of the SNF May 28, 2019
Rainbow Investment Company Organization, San Diego, CA Corporation Adp of the SNF Dec 1, 2014
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Soon Burnam Individual Corporate OfficerSecretary Mission Trails Healthc Sep 10, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Amir H Fahid
    • Internal Medicine Physician
    • Coronado, CA
    • NPI 1568740355

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 37

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

View all 37

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": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1689077588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423034",
            "telephone_number": "619-460-4444",
            "fax_number": "619-460-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8787 CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423034",
            "telephone_number": "619-460-4444",
            "fax_number": "619-460-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION TRAILS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "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": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "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": [
        {
            "organization_name": "Grossmont Post Acute Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grossmont Post Acute Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.