1440 South Euclid St LLC
Organization Active NPI Skilled Nursing Facility · Anaheim, CA
NPI 1740275486 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1740275486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 1440 SOUTH EUCLID ST LLC
- Practice address
- 1440 S Euclid St
Anaheim, CA 92802-2156 - Phone
- (714) 535-7264
- Fax
- (714) 535-0940
- NPI assigned
- Sep 19, 2005
- Organization subpart
- No
Authorized official
- Name
- Caroline L Boyer
- Title
- Director of Patient Accounting
- Phone
- (818) 367-9546
Facilities with the same owner 27
Affiliated clinicians 5
-
Yixing Li, DO
-
Alicia Montanez, MD
-
Octaviano A Roges, M.D.
-
Reza Talebi Dolouei, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Buena Vista Care Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 99 · 90.0 residents per day on average
- Chain
- Cambridge Healthcare Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 055459
- Legal name
- 1440 SOUTH EUCLID ST LLC
- Doing business as
- BUENA VISTA CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Nov 1, 2024
- Beds
- 99
- Ownership / control type
- Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 20, 2000 in CA
- Enrollment address
- 1440 S Euclid St
Anaheim, CA 92802-2156 - Nursing home name
- BUENA VISTA CARE CENTER
- Affiliated entity
- CAMBRIDGE HEALTHCARE SERVICES
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Win Win Enterprises, LLC |
5% Or Greater Direct Ownership Interest | Dec 1, 2006 | 58.06% |
| Cambridge Healthcare Services LLC |
Other | Jul 1, 2010 | |
| Wolff Living Trust DTD 03/09/2000 |
5% Or Greater Direct Ownership Interest | Dec 1, 2006 | 6.94% |
| Ira Smedra |
5% Or Greater Direct Ownership Interest | Dec 1, 2006 | 20% |
| Corporate Officer |
Dec 1, 2006 | ||
| Shersher LP |
5% Or Greater Direct Ownership Interest | Dec 1, 2006 | 6.94% |
| Jacob Wintner |
5% Or Greater Indirect Ownership Interest | Dec 1, 2006 | 14.51% |
| Corporate Officer |
Dec 1, 2006 | ||
| Operational/Managerial Control |
Dec 1, 2006 | ||
| The Wintner Living Trust Dated 7/08/1992 |
5% Or Greater Indirect Ownership Interest | Dec 1, 2006 | 29.03% |
| Pegah Sahebifard |
W-2 Managing Employee |
Apr 6, 2020 | |
| Operational/Managerial Control |
Apr 6, 2020 | ||
| Heather Langford |
Other |
May 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110518000262 | CA | Part a Provider - Skilled Nursing Facility | 3678759172 | Practice locations: Anaheim, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | CA | Yes |
Addresses
Primary practice location
1440 S Euclid St
Anaheim, CA 92802-2156
Mailing address
1440 S Euclid St
Anaheim, CA 92802-2156
Phone (714) 535-7264
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT05459J | Medicaid | CA |
Other names
- buena vista care center
Other providers in Anaheim, CA
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- 3G & a Homecare LLC
- 3Paul'S Transportation
- 986 Infusion Pharmacy #1 Inc.
- A & a Group LLC - True Care Living
All providers in Anaheim, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.