NPIMap

Organization Active NPI

Community Care Rehab Center LLC

Doing business as Community Care and Rehab Center

  • Skilled Nursing Facility
  • Riverside, CA
National Provider Identifier
1700186590
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMMUNITY CARE REHAB CENTER LLC
Doing business as
Community Care and Rehab Center
Practice address
4070 Jurapa Ave
Riverside, CA 92506-2234
Phone
(951) 680-6500
Fax
(951) 680-6510
NPI assigned
Oct 26, 2010
Last updated
Dec 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Authorized official

Name
Irving Bauman
Title
Owner
Phone
(714) 577-3880

Specialties & licenses 1

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

Addresses

Primary practice location

4070 Jurapa Ave
Riverside, CA 92506-2234

Mailing address

3050 Saturn St
Ste 201
Brea, CA 92821-6221
Phone (714) 577-3880

Other names 1

  • Community Care and Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110105000828 CA Part A Provider - Skilled Nursing Facility 4486843521 Practice locations: Riverside, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700186590. Details of each certification follow.

Skilled nursing facility certification: CCN 055409

Legal name
COMMUNITY CARE REHAB CENTER LLC
Doing business as
COMMUNITY CARE AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
May 9, 2025
Beds
162
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Nov 1, 2010
Organization structure
LLCProprietary
Incorporated
Aug 6, 2010 in CA
Enrollment address
4070 Jurupa Ave
Riverside, CA 92506-2234
Nursing home name
COMMUNITY CARE AND REHABILITATION CENTER
Affiliated entity
DAVID JOHNSON

Care Compare: Nursing home

Medicare Care Compare
Listed as
Community Care and Rehabilitation CenterCCN 055409 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
162153.3 residents per day on average
Chain
David Johnson48 facilities in the chain

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
05D0726120Community Care and Rehabilitation Center4070 Jurupa Avenue, Riverside, CA 92506Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Sun Mar Management Services Organization, Brea, CA Corporation Operational/Managerial Control Oct 12, 1989
Adp of the SNF Oct 12, 1989
Peter Smith Individual Operational/Managerial Control Mar 21, 2021
David a Johnson Individual 5% Or Greater Indirect Ownership InterestOwner and Director Aug 6, 2010 37.5%
Corporate OfficerLLC Manager Aug 6, 2010
Micheal D Oxford Individual Operational/Managerial Control Jan 3, 2022
Adp of the SNF Jan 3, 2022
Frank a Johnson Individual 5% Or Greater Indirect Ownership InterestOwner and Director Aug 6, 2010 37.5%
Corporate OfficerManager Aug 6, 2010
Operational/Managerial Control Aug 6, 2010
Community Care Rehab Center LLC Organization, Brea, CA Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 22, 2010 100%
Operational/Managerial Control Dec 22, 2010
Adp of the SNF Dec 22, 2010
Riverside Nursing Home Associates Two, LP Organization, Hunt Valley, MD Real estate investment trust (REIT) Adp of the SNF Feb 11, 2025
Joshua Kochek Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Eli Marmur Individual 5% Or Greater Indirect Ownership InterestOwner Aug 6, 2010 25%
Organization, Chicago, IL Corporation, Financial institution Adp of the SNF Sep 1, 2021
Adrian Dehghanmanesh Individual Corporate OfficerCfo Jul 1, 2021
Operational/Managerial Control Jun 1, 2021
Adp of the SNF Jun 1, 2021
Mary Farrales Individual Adp of the SNF Jan 1, 2023
Andro N Sharobiem Individual Operational/Managerial Control Jun 1, 2022
Adp of the SNF Jun 1, 2022
Jordan Mader Individual Operational/Managerial Control Sep 28, 2023
Adp of the SNF Sep 28, 2023

Owners & managing parties with NPI records 2

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

Facilities with the same owner 6

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 5

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": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1700186590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 SATURN ST",
            "address_2": "STE 201",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216221",
            "telephone_number": "714-577-3880",
            "fax_number": "714-577-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 JURAPA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062234",
            "telephone_number": "951-680-6500",
            "fax_number": "951-680-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "BAUMAN",
        "authorized_official_first_name": "IRVING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-577-3880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.