NPIMap

Organization Active NPI

Anaheim Terrace Care Center, LLC

Doing business as Anaheim Terrace Care Center

  • Skilled Nursing Facility
  • Anaheim, CA
National Provider Identifier
1790768083
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
080000647 Issued in CA
Legal business name
ANAHEIM TERRACE CARE CENTER, LLC
Doing business as
Anaheim Terrace Care Center
Practice address
141 S. Knott Ave.
Anaheim, CA 92804-1406
Phone
(714) 821-7310
NPI assigned
Nov 21, 2005
Last updated
Feb 24, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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) 468-4752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 080000647 CA Primary

Addresses

Primary practice location

141 S. Knott Ave.
Anaheim, CA 92804-1406

Mailing address

141 S. Knott Ave.
Anaheim, CA 92804-1406
Phone (714) 821-7310

Other names 1

  • Anaheim Terrace Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030819000050 CA Part A Provider - Skilled Nursing Facility 9931010444 Practice locations: Anaheim, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790768083. Details of each certification follow.

Skilled nursing facility certification: CCN 056076

Legal name
ANAHEIM TERRACE CARE CENTER, LLC
Doing business as
ANAHEIM TERRACE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1975
Last certification
May 21, 2025
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
141 S Knott Ave
Anaheim, CA 92804-1406
Nursing home name
ANAHEIM TERRACE CARE CENTER
Affiliated entity
GENESIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Anaheim Terrace Care CenterCCN 056076 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 1, 1975
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9989.3 residents per day on average
Chain
Genesis Healthcare184 facilities in the chain

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
05D0582540Anaheim Terrace Care Center141 S Knott Ave, Anaheim, CA 92804Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
9560 Pico LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 50%
Bold Quail Holdings LLC Organization, Los Angeles, CA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 100%
Pico Ar LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 50%
BQ Operations Holdings LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2021 100%
Newgen LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2021 50%
Avrohom L Tress Individual 5% Or Greater Indirect Ownership InterestVice President Feb 1, 2021 50%
Pamela Shaw Individual Operational/Managerial Control Feb 1, 2021
Adp of the SNF Feb 1, 2021
Aaron H Robin Individual 5% Or Greater Indirect Ownership InterestPresident Feb 1, 2021 50%

Facilities with the same owner 45

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

View all 45

Practitioners & affiliated clinicians

Practitioners 1

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 5

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": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1790768083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 S. KNOTT AVE.",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041406",
            "telephone_number": "714-821-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 S. KNOTT AVE.",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041406",
            "telephone_number": "714-821-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAHEIM TERRACE CARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT CARE LLC",
        "enumeration_date": "2005-11-21",
        "last_updated": "2016-02-24",
        "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": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "080000647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anaheim Terrace Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.