NPIMap

Organization Active NPI

Lancaster SNF Healthcare, LLC

Doing business as Mirage Post Acute

  • Skilled Nursing Facility
  • Lancaster, CA
National Provider Identifier
1801584164
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LANCASTER SNF HEALTHCARE, LLC
Doing business as
Mirage Post Acute
Practice address
44445 15TH St W
Lancaster, CA 93534-2801
Phone
(661) 948-7501
NPI assigned
Apr 25, 2023
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

44445 15TH St W
Lancaster, CA 93534-2801

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Mirage Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240224000342 CA Part A Provider - Skilled Nursing Facility 3375988843 Practice locations: Lancaster, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801584164. Details of each certification follow.

Skilled nursing facility certification: CCN 056039

Legal name
LANCASTER SNF HEALTHCARE LLC
Doing business as
MIRAGE POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 17, 1969
Last certification
Jan 17, 2025
Beds
299
Ownership / control type
Partnership
Multi-facility organization
PACS
Organization structure
LLCProprietary
Incorporated
Apr 19, 2023 in CA
Enrollment address
44445 15TH St W
Lancaster, CA 93534-2801
Nursing home name
MIRAGE POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mirage Post AcuteCCN 056039 · 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 - Partnership
Certified
Feb 17, 1969
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
299267.5 residents per day on average
Chain
Pacs Group274 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
3Fines totaling $153,991

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
05D0587939Mirage Post Acute44445 15TH St W, Lancaster, CA 93534Certificate 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
Jason H Murray Individual 5% Or Greater Indirect Ownership InterestPresident/Ceo Jun 15, 2023 50%
Corporate OfficerPresident/Ceo Jun 15, 2023
John T Mitchell Individual Corporate OfficerVice President/Asst Secretary Jun 15, 2023
Frederick G Apt Individual Corporate OfficerVice President/Asst Treasurer Jun 15, 2023
Spencer Jack Individual W-2 Managing EmployeeAdministrator Jun 15, 2023
Operational/Managerial ControlAdministrator Jun 15, 2023
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Direct Ownership Interest Jun 15, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 15, 2023 100%
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 15, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership InterestVice President/Cfo/Secretary Jun 15, 2023 50%
Corporate OfficerVice President/Cfo/Secretary Jun 15, 2023

Facilities with the same owner 186

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

View all 186

Practitioners & affiliated clinicians

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": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1801584164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44445 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342801",
            "telephone_number": "661-948-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER SNF HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mirage Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mirage Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.