NPIMap

Organization Active NPI

Guadalupe County Hospital Board

Doing business as Northeast Rehabilitation and Healthcare Center

  • Skilled Nursing Facility
  • San Antonio, TX
National Provider Identifier
1760478200
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
111489 Issued in TX
Legal business name
GUADALUPE COUNTY HOSPITAL BOARD
Doing business as
Northeast Rehabilitation and Healthcare Center
Practice address
603 Corinne Dr
San Antonio, TX 78218-3303
Phone
(210) 824-7331
Fax
(210) 824-1334
NPI assigned
Sep 20, 2005
Last updated
Mar 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Authorized official

Name
Soon Burnam
Title
Treasurer of Management Company
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 111489 TX Primary

Addresses

Primary practice location

603 Corinne Dr
San Antonio, TX 78218-3303

Mailing address

603 Corinne Dr
San Antonio, TX 78218-3303
Phone (210) 824-7331

Other identifiers 1

IdentifierTypeStateIssuer
001004268MedicaidTX

Other names 1

  • Northeast Rehabilitation and Healthcare Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220414001656 TX Part A Provider - Skilled Nursing Facility 5496653842 Practice locations: San Antonio, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760478200. Details of each certification follow.

Skilled nursing facility certification: CCN 455754

Legal name
GUADALUPE COUNTY HOSPITAL BOARD
Doing business as
NORTHEAST REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jun 30, 1988
Last certification
Mar 21, 2025
Beds
120
Ownership / control type
Hospital District
Most recent change of ownership
Mar 1, 2022
Organization structure
OtherNon-profit
Incorporated
Nov 25, 2005 in TX
Enrollment address
603 Corinne Dr
San Antonio, TX 78218-3303
Nursing home name
NORTHEAST REHABILITATION AND HEALTHCARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Northeast Rehabilitation and Healthcare CenterCCN 455754 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Jun 30, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120100.2 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
2Fines totaling $15,616

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Guadalupe Hospital County Board41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Guadalupe County Hospital Board Organization, Seguin, TX 5% Or Greater Direct Ownership Interest Mar 1, 2022 100%
Heather Brady Individual W-2 Managing EmployeeAdministrator Mar 1, 2022
Operational/Managerial ControlAdministrator Mar 1, 2022
Salado Creek Senior Care Inc. Organization, San Antonio, TX Corporation, For-profit Operational/Managerial Control Mar 1, 2022
Kody Gann Individual Corporate OfficerChief Finance Officer Apr 3, 2021
Soon Burnam Individual Operational/Managerial ControlTreasurer of Management Company Mar 1, 2022

All facility ownership & control disclosures 28

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Guadalupe Regional Medical CenterSeguin, TX, CCN 45T104 Hospital Operational/Managerial Control Jan 1, 1975
Guadalupe Regional Medical CenterSeguin, TX, CCN 450104 Hospital Operational/Managerial Control Jan 1, 1975
Avir at SeguinSeguin, TX, CCN 675641 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2015
Morningside ManorSan Antonio, TX, CCN 455523 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Park Place Care CenterGeorgetown, TX, CCN 675915 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Five Points of PflugervillePflugerville, TX, CCN 675913 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Avir at SchertzSchertz, TX, CCN 676301 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 3, 2017
Avir at LulingLuling, TX, CCN 676292 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 3, 2017
Granite Mesa Health CenterMarble Falls, TX, CCN 676220 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
The Courtyard Rehabilitation and Healthcare CenterVictoria, TX, CCN 675766 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
San Marcos Rehabilitation and Healthcare CenterSan Marcos, TX, CCN 675651 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Legend Oaks Healthcare and Rehabilitation - KyleKyle, TX, CCN 676272 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Legend Oaks Healthcare and Rehabilitation - North AustinAustin, TX, CCN 676238 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Guadalupe County Hospital BoardNew Braunfels, TX, CCN 676392 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
Hunters Pond Rehabilitation and HealthcareSan Antonio, TX, CCN 676331 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2019
Hays Nursing and Rehabilitation CenterSan Marcos, TX, CCN 455960 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2020
Eden HomeNew Braunfels, TX, CCN 455618 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Trustee of the SNF		 May 1, 2021
May 1, 2021
Sedona Trace Health and Wellness CenterAustin, TX, CCN 676459 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2021
Avir at Bay CityBay City, TX, CCN 455643 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Avir at BellvilleBellville, TX, CCN 676164 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jun 1, 2022
Avir at SealySealy, TX, CCN 676166 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2022
Arbor View Nursing & RehabilitationKerrville, TX, CCN 455724 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Nov 1, 2022
Nov 1, 2022
Nov 1, 2022
Avir at PecosPecos, TX, CCN 675881 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Westover Hills Rehabilitation and HealthcareSan Antonio, TX, CCN 676281 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2023
Avir at LongviewLongview, TX, CCN 455678 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2025
Avir at Cowhorn CreekTexarkana, TX, CCN 675949 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2025
Avir at TexarkanaTexarkana, TX, CCN 676069 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2025
Guadalupe Regional HospiceSeguin, TX, CCN 451541 Hospice 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1991

Facilities with the same owner 28

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

View all 28

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 2

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": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1760478200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 CORINNE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183303",
            "telephone_number": "210-824-7331",
            "fax_number": "210-824-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 CORINNE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183303",
            "telephone_number": "210-824-7331",
            "fax_number": "210-824-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALUPE COUNTY HOSPITAL BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER OF MANAGEMENT COMPANY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "111489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004268",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Northeast Rehabilitation and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northeast Rehabilitation and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.