NPIMap

Organization Active NPI

College Avenue Operating LLC

  • Skilled Nursing Facility
  • Conway, AR
National Provider Identifier
1780385120
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COLLEGE AVENUE OPERATING LLC
Practice address
3501 College Ave
Conway, AR 72034-7281
Phone
(501) 329-9879
NPI assigned
Mar 13, 2023
Last updated
Aug 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Authorized official

Name
Yisroel Ganz
Title
Director
Phone
(732) 366-5705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3501 College Ave
Conway, AR 72034-7281

Mailing address

1999 Cedarbridge Ave Ste 3B
Lakewood, NJ 08701-7048
Phone (732) 366-5705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250113003373 AR Part A Provider - Skilled Nursing Facility 7719415108 Practice locations: Conway, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780385120. Details of each certification follow.

Skilled nursing facility certification: CCN 045313

Legal name
COLLEGE AVENUE OPERATING LLC
Doing business as
THE BLOSSOMS AT CONWAY REHAB & NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 22, 1996
Last certification
May 21, 2025
Beds
104
Ownership / control type
Corporation
Multi-facility organization
Oasis Arkansas Group
Most recent change of ownership
Apr 1, 2023
Organization structure
LLCProprietary
Incorporated
Feb 28, 2023 in AR
Enrollment address
3501 College Ave
Conway, AR 72034-7281
Nursing home name
THE BLOSSOMS AT CONWAY REHAB & NURSING CENTER
Affiliated entity
THE BLOSSOMS REHAB & NURSING CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Blossoms at Conway Rehab & Nursing CenterCCN 045313 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 22, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10472.7 residents per day on average
Chain
The Blossoms Rehab & Nursing Center23 facilities in the chain
Penalties (3 years)
1Fines totaling $8,021

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

3501 College Ave
Conway, AR 72034
Phone (501) 320-9879

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Evgueni Roudachevski Individual Adp of the SNF Apr 5, 2021
Hansen Hunter LLC Organization, Portland, OR LLC, Consulting firm, For-profit Adp of the SNF Mar 15, 2021
Reliant Pro Rehab LLC Organization, Plano, TX LLC, For-profit Adp of the SNF Apr 5, 2023
Organization, Lakewood, NJ Corporation, Financial institution, Consulting firm, For-profit Adp of the SNF Apr 5, 2023
Individual Adp of the SNF Apr 5, 2023
Matisyohu Herzka Individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.33%
Sisah Staffing Solutions LLC Organization, Newark, NJ LLC, Medical staffing company, For-profit Operational/Managerial Control Apr 5, 2023
Adp of the SNF Apr 5, 2023
Aks Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.34%
David E Rainosek Individual Adp of the SNF Apr 5, 2023
LTC Consulting Services LLC Organization, Lakewood, NJ LLC, Consulting firm, For-profit Operational/Managerial Control Apr 5, 2023
Adp of the SNF Apr 5, 2023
Abraham Schreiber Individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.34%
Diamond Opco Holding LLC Organization, Hot Springs, AR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2023 100%
MH Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.33%
Stacy Luster Individual Adp of the SNF Apr 1, 2023
ZCS Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.33%
Oasis Health Care Group, LLC Organization, Lakewood, NJ LLC, Management services company Operational/Managerial Control Apr 5, 2023
Adp of the SNF Apr 5, 2023
Tammy L Romero Individual Operational/Managerial Control Apr 5, 2025
Adp of the SNF Apr 5, 2025
Bilal Sadiq Individual Adp of the SNF Apr 5, 2023
Shlomo Z Scheinbaum Individual 5% Or Greater Indirect Ownership InterestCeo Apr 1, 2023 33.33%
Corporate OfficerCeo Apr 1, 2023 100%
Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

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": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1780385120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 CEDARBRIDGE AVE STE 3B",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017048",
            "telephone_number": "732-366-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347281",
            "telephone_number": "501-329-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE AVENUE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "GANZ",
        "authorized_official_first_name": "YISROEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-366-5705"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.