2575 Airline Drive Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

2575 AIRLINE DRIVE OPCO LLC

Practice address

2575 Airline Dr
Bossier City, LA 71111-5812

Phone

(318) 746-7466

Fax

(318) 747-0014

NPI assigned

Feb 27, 2024

Last updated

Feb 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shlomo Mushell

Title

Manager

Phone

(917) 251-5131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710743752. Details of each certification follow.

• CCN 195323 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 195323

Legal name

2575 AIRLINE DRIVE OPCO LLC

Doing business as

HERITAGE MANOR HEALTH & REHAB

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Mar 1, 1995

Last certification

Jul 16, 2024

Beds

64

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Pelican Care Centers

Organization structure

LLCProprietary

Enrollment address

2575 Airline Dr
Bossier City, LA 71111-5812

Nursing home name

HERITAGE MANOR HEALTH & REHAB

Listed as

Heritage Manor Health & RehabCCN 195323 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Mar 1, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6453.9 residents per day on average

Penalties (3 years)

1Fines totaling $73,487

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 8

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

Owners & managing parties with NPI records 1

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

• Pat F Bass, M.D.

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1952321820

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 1

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

• 4405 Airline Drive Opco LLC

  • Skilled Nursing Facility
  • Bossier City, LA
  • NPI 1437915477

  Airline Drive Bossier LLC, Doodle la Holdings, LLC, RMG Enterprises Solutions, Inc.

  CMS ownership

Practitioners 3

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.

• Michael Alon Angelo, M.D.

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1295723955
  NPD (past)
• Pat F Bass, M.D.

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1952321820
  NPD (past)
• Mairus Taliaferro McFarland, M.D.

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1114945656
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mairus Taliaferro McFarland, M.D.

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1114945656

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1710743752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115812",
            "telephone_number": "318-746-7466",
            "fax_number": "318-747-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115812",
            "telephone_number": "318-746-7466",
            "fax_number": "318-747-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2575 AIRLINE DRIVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "MUSHELL",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-251-5131"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• A&L Health and Wellness Services

• Skilled Nursing Facility in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.