Organization Active NPI

The Manor of Kenosha LLC

  • Skilled Nursing Facility
  • Kenosha, WI
National Provider Identifier
1730665159
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE MANOR OF KENOSHA LLC
Practice address
3100 Washington Rd
Kenosha, WI 53144-1604
Phone
(847) 983-4860
NPI assigned
Jul 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
David Merzel
Title
Cfo
Phone
(847) 983-4860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3100 Washington Rd
Kenosha, WI 53144-1604

Mailing address

5454 Fargo Ave
Skokie, IL 60077-3210
Phone (847) 983-4860

Other identifiers 1

IdentifierTypeStateIssuer
00000000MedicaidWI

Other names 1

  • Avina of Kenosha Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190315002024 WI Part A Provider - Skilled Nursing Facility 0648510362 Practice locations: Kenosha, WI

Skilled nursing facility certification: CCN 525179

Legal name
THE MANOR OF KENOSHA LLC
Doing business as
AVINA OF KENOSHA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 14, 1969
Last certification
Apr 29, 2024
Beds
153
Ownership / control type
Corporation
Multi-facility organization
CROSSROADS CARE CENTER
Organization structure
LLCProprietary
Enrollment address
3100 Washington Rd
Kenosha, WI 53144-1604
Nursing home name
AVINA OF KENOSHA
Affiliated entity
AVINA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avina of KenoshaCCN 525179
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 14, 1969
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
15388.1 residents per day on average
Chain
Avina Healthcare9 facilities in the chain
Penalties (3 years)
2Fines totaling $33,989

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Yaakov Brandman Individual 5% Or Greater Direct Ownership Interest Nov 1, 2018 10%
Igor Rebel Individual 5% Or Greater Direct Ownership Interest Nov 1, 2018 20%
Cecilia Topper Individual 5% Or Greater Direct Ownership Interest Jul 9, 2024 16%
Aaron Topper Individual Operational/Managerial Control Jul 10, 2025
Joseph Brandman Individual Operational/Managerial Control Nov 1, 2018
Akiva Brandman Individual 5% Or Greater Direct Ownership Interest Nov 1, 2018 10%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1730665159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 FARGO AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773210",
            "telephone_number": "847-983-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441604",
            "telephone_number": "847-983-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MANOR OF KENOSHA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "MERZEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-983-4860"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Avina of Kenosha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.