NPIMap

Organization Active NPI

The Grove Health and Rehab Center LLC

  • Skilled Nursing Facility
  • Jacksonville, IL
National Provider Identifier
1760172712
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE GROVE HEALTH AND REHAB CENTER LLC
Practice address
873 Grove St
Jacksonville, IL 62650-2828
Phone
(217) 479-3400
NPI assigned
May 12, 2023
Last updated
May 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Shully Lichtman
Title
Manager of the Manager
Phone
(217) 479-3400

Specialties & licenses 1

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

Addresses

Primary practice location

873 Grove St
Jacksonville, IL 62650-2828

Mailing address

575 Route 70
Brick, NJ 08723-4042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230802003096 IL Part A Provider - Skilled Nursing Facility 3870954134 Practice locations: Jacksonville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760172712. Details of each certification follow.

Skilled nursing facility certification: CCN 146059

Legal name
THE GROVE HEALTH AND REHAB CENTER LLC
Doing business as
THE GROVE HEALTH AND REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 19, 2004
Last certification
Sep 13, 2024
Beds
199 (175 certified)
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
873 Grove St
Jacksonville, IL 62650-2828
Nursing home name
GROVE HEALTH & REHAB CTR, THE
Affiliated entity
SUMMIT HEALTHCARE CONSULTING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grove Health & Rehab Ctr, theCCN 146059 · 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
Apr 19, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
175144.1 residents per day on average
Chain
Summit Healthcare Consulting9 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
3Fines totaling $105,079

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
The Grove Health and Rehab Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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
Shalom Lichtman Individual Corporate OfficerManager of Government Enrollment Jul 1, 2023
Operational/Managerial ControlManager of the Manager Jul 1, 2023
Light Man LLC Organization, Chicago, IL LLC, For-profit Operational/Managerial Control Jul 1, 2023
Apogee TR Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest Jul 1, 2023 20%
SC Illinois Holdco II LLC Organization, Brick, NJ LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
Stephanie Smith Individual W-2 Managing EmployeeFacility Administrator Jul 1, 2023
SC Illinois II TBD Holdco LLC Organization, Brick, NJ LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2023 100%

Facilities with the same owner 17

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

View all 17

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": "1683849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1760172712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 GROVE ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502828",
            "telephone_number": "217-479-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GROVE HEALTH AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "LICHTMAN",
        "authorized_official_first_name": "SHULLY",
        "authorized_official_title_or_position": "MANAGER OF THE MANAGER",
        "authorized_official_telephone_number": "217-479-3400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.