NPIMap

Organization Active NPI

400 29TH Street Northeast Operations LLC

Doing business as Linden Grove Health Care Center

  • Skilled Nursing Facility
  • Puyallup, WA
National Provider Identifier
1790160604
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000 Issued in WA
Legal business name
400 29TH STREET NORTHEAST OPERATIONS LLC
Doing business as
Linden Grove Health Care Center
Practice address
400 29TH St NE
Puyallup, WA 98372-6774
Phone
(253) 840-4400
Fax
(253) 840-4411
NPI assigned
Jul 22, 2015
Last updated
Jul 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Authorized official

Name
Michael T Berg
Title
Assistant Secretary
Phone
(505) 468-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0000 WA Primary

Addresses

Primary practice location

400 29TH St NE
Puyallup, WA 98372-6774

Mailing address

400 29TH St NE
Puyallup, WA 98372-6774
Phone (253) 840-4400

Other names 1

  • Linden Grove Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151221000182 WA Part A Provider - Skilled Nursing Facility 2163723909 Practice locations: Puyallup, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790160604. Details of each certification follow.

Skilled nursing facility certification: CCN 505485

Legal name
400 29TH STREET NORTHEAST OPERATIONS LLC
Doing business as
LINDEN GROVE HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 4, 1993
Last certification
Jan 29, 2025
Beds
130
Ownership / control type
Limited Liability Corporation
Multi-facility organization
BQ Operations Holdings LLC
Organization structure
LLCProprietary
Enrollment address
400 29TH St NE
Puyallup, WA 98372-6774
Nursing home name
LINDEN GROVE HEALTH CARE CENTER
Affiliated entity
GENESIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Linden Grove Health Care CenterCCN 505485 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 4, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
130108.2 residents per day on average
Chain
Genesis Healthcare184 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
6Fines totaling $180,646

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Neel Ramesh Chheda Individual Operational/Managerial Control Dec 1, 2023
Adp of the SNF Dec 1, 2023
400 29TH Street Northeast Property LLC Organization, Los Angeles, CA LLC Adp of the SNF Feb 1, 2020
9560 Pico LLC Organization, Los Angeles, CA LLC Adp of the SNF Apr 20, 2026
Indirect Ownership Interest Apr 20, 2026 50%
Bold Quail Holdings LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Feb 3, 2020 100%
BQ Master Tenant LLC Organization, Los Angeles, CA LLC, Holding company Adp of the SNF Jul 8, 2026
Pico Ar LLC Organization, Los Angeles, CA LLC Adp of the SNF Apr 20, 2026
Indirect Ownership Interest Apr 20, 2026 50%
BQ Realty Holdings LLC Organization, Los Angeles, CA Corporation, LLC Adp of the SNF Feb 1, 2020
BQ Operations Holdings LLC Organization, Los Angeles, CA LLC, Holding company, Chain home office 5% Or Greater Direct Ownership Interest Feb 3, 2020 100%
Newgen LLC Organization, Los Angeles, CA Corporation, LLC 5% Or Greater Indirect Ownership Interest Apr 1, 2020 100%
Adp of the SNF Apr 20, 2026
Newgen Administrative Services, LLC Organization, Los Angeles, CA LLC Adp of the SNF Feb 1, 2020
Avrohom L Tress Individual 5% Or Greater Indirect Ownership Interest50 Owner of New Generation Healt Feb 3, 2020 50%
Corporate OfficerVice President Feb 3, 2020 100%
Operational/Managerial Control Feb 1, 2020
Managing Control - Governing BodyVice President Nov 3, 2025
Adp of the SNF Feb 1, 2020
Pam Calrson Individual Operational/Managerial Control Dec 27, 2023
Adp of the SNF Dec 27, 2023
Michael T Berg Individual Corporate OfficerTreasurer Feb 3, 2020
Operational/Managerial Control Apr 1, 2020
Aaron H Robin Individual 5% Or Greater Indirect Ownership Interest50 Owner of New Generation Health Feb 3, 2020 50%
Corporate OfficerPres, Asst Secy, Asst Treasurer Feb 3, 2020 100%
Operational/Managerial Control Feb 1, 2020
Managing Control - Governing BodyPresident Nov 3, 2025
Adp of the SNF Feb 1, 2020
Robert Rowe Individual Operational/Managerial Control Jun 16, 2023
Adp of the SNF Jun 16, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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 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": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1790160604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 29TH ST NE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983726774",
            "telephone_number": "253-840-4400",
            "fax_number": "253-840-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 29TH ST NE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983726774",
            "telephone_number": "253-840-4400",
            "fax_number": "253-840-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "400 29TH STREET NORTHEAST OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Linden Grove Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.