NPIMap

Organization Active NPI

Lacey SNF Operations LLC

  • Skilled Nursing Facility
  • Lacey, WA
National Provider Identifier
1760180780
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LACEY SNF OPERATIONS LLC
Practice address
4524 Intelco Loop SE
Lacey, WA 98503-5941
Phone
(360) 491-9890
NPI assigned
Feb 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Joseph Lieberman
Title
Vice President of Procurement
Phone
(646) 275-4510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4524 Intelco Loop SE
Lacey, WA 98503-5941

Mailing address

4524 Intelco Loop SE
Lacey, WA 98503-5941

Other names 1

  • Lacey Post Acute & Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230602000434 WA Part A Provider - Skilled Nursing Facility 6002271228 Practice locations: Lacey, WA

Skilled nursing facility certification: CCN 505525

Legal name
LACEY SNF OPERATIONS LLC
Doing business as
LACEY POST ACUTE & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 25, 2012
Last certification
Aug 23, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Hill Valley Healthcare
Organization structure
LLCProprietary
Incorporated
Feb 8, 2023 in NV
Enrollment address
4524 Intelco Loop SE
Lacey, WA 98503-5941
Nursing home name
LACEY POST ACUTE & REHABILITATION
Affiliated entity
HILL VALLEY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lacey Post Acute & RehabilitationCCN 505525
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 25, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120118.6 residents per day on average
Chain
Hill Valley Healthcare43 facilities in the chain
Penalties (3 years)
1Fines totaling $7,443

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
50D2034884Lacey Post Acute & Rehabilitation4524 Intelco Loop SE, Lacey, WA 98503Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Sabrina 1818 Holdings LLC Organization, Flushing, NY LLC 5% Or Greater Indirect Ownership Interest Feb 8, 2023 48.75%
Daniel a Gottesman Individual OtherTrustee Feb 8, 2023
Saessy Irrevocable Trust Organization, Far Rockaway, NY 5% Or Greater Indirect Ownership Interest Feb 8, 2023 46%
Lacey SNF Operations Manager LLC Organization, Woodmere, NY LLC Operational/Managerial Control Apr 1, 2023
Steven a Schwartz Individual Corporate OfficerPresident Apr 1, 2023
Operational/Managerial ControlPresident Apr 1, 2023
Shimon Idels Individual Corporate OfficerCeo Apr 1, 2023
Operational/Managerial ControlCeo Apr 1, 2023
Heather Bennet-Idels Individual OtherTrustee of Tatiriq Irrevocable T Feb 28, 2023
Wash 6 SNF Operations Holdings LLC Organization, Woodmere, NY LLC 5% Or Greater Direct Ownership Interest Feb 8, 2023 100%
Tatiriq Irrevocable Trust Organization, Flushing, NY 5% Or Greater Indirect Ownership Interest Feb 8, 2023 46%
Lion 26 Holdings LLC Organization, Far Rockaway, NY LLC 5% Or Greater Indirect Ownership Interest Feb 8, 2023 48.75%

Facilities with the same owner 47

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

  • FH SNF Operations LLC
    • Skilled Nursing Facility
    • Seattle, WA
    • NPI 1902614936

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
  • Gig Harbor SNF Operations LLC
    • Skilled Nursing Facility
    • Gig Harbor, WA
    • NPI 1033817051

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Wash 6 SNF Operations Holdings LLC

    CMS ownership
  • Lynnwood SNF Operations LLC
    • Skilled Nursing Facility
    • Lynnwood, WA
    • NPI 1689372609

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Wash 6 SNF Operations Holdings LLC

    CMS ownership
  • Salmon Creek SNF Operations LLC
    • Skilled Nursing Facility
    • Vancouver, WA
    • NPI 1851099873

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Wash 6 SNF Operations Holdings LLC

    CMS ownership
  • Tacoma SNF Operations LLC
    • Skilled Nursing Facility
    • Tacoma, WA
    • NPI 1215635230

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Wash 6 SNF Operations Holdings LLC

    CMS ownership
  • Winston SNF Operations LLC
    • Skilled Nursing Facility
    • Spokane, WA
    • NPI 1306544325

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Wash 6 SNF Operations Holdings LLC

    CMS ownership
  • Woodard SNF Operations LLC
    • Skilled Nursing Facility
    • Olympia, WA
    • NPI 1982402939

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
  • Alexandria SNF Operations LLC
    • Skilled Nursing Facility
    • Alexandria, VA
    • NPI 1346951761

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
  • Amherst SNF Operations LLC
    • Skilled Nursing Facility
    • Amherst, VA
    • NPI 1174297063

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
  • Bedford SNF Operations LLC
    • Skilled Nursing Facility
    • Bedford, VA
    • NPI 1508530387

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
  • Belington SNF Operations LLC
    • Skilled Nursing Facility
    • Belington, WV
    • NPI 1811670607

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
  • Beth Sholom SNF Operations LLC
    • Skilled Nursing Facility
    • Richmond, VA
    • NPI 1881388510

    Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust

    CMS ownership
View all 47

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1760180780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4524 INTELCO LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 INTELCO LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035941",
            "telephone_number": "360-491-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACEY SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PROCUREMENT",
        "authorized_official_telephone_number": "646-275-4510"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lacey Post Acute & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.