NPIMap

Organization Active NPI

Douglas Fir Holdings, LLC

  • Skilled Nursing Facility
  • Huntington Beach, CA
National Provider Identifier
1821027632
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
060000206 Issued in CA
Legal business name
DOUGLAS FIR HOLDINGS, LLC
Practice address
8382 Newman Ave
Huntington Beach, CA 92647-7038
Phone
(714) 842-5551
Fax
(714) 848-5359
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 060000206 CA Primary

Addresses

Primary practice location

8382 Newman Ave
Huntington Beach, CA 92647-7038

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other identifiers 3

IdentifierTypeStateIssuer
LTC70171FMedicaidCA
1821027632MedicaidCA
ZZT05888HMedicaidCA

Other names 1

  • Huntington Valley Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061005000535 CA Part A Provider - Skilled Nursing Facility 8426054933 Practice locations: Huntington Beach, CA

Skilled nursing facility certification: CCN 055888

Legal name
DOUGLAS FIR HOLDINGS LLC
Doing business as
HUNTINGTON VALLEY HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1968
Last certification
Apr 7, 2025
Beds
144
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS Inc
Organization structure
LLCProprietary
Incorporated
Mar 31, 2000 in CA
Enrollment address
8382 Newman Ave
Huntington Beach, CA 92647-7038
Nursing home name
HUNTINGTON VALLEY HEALTHCARE CENTER
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Huntington Valley Healthcare CenterCCN 055888
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 1, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
144125.9 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
4Fines totaling $34,221

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
05D0577454Huntington Valley Healthcare Center8382 Newman Avenue, Huntington Beach, CA 92647Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Andrew Stephensen Individual W-2 Managing EmployeeAdministrator Aug 7, 2023
Operational/Managerial ControlAdministrator Aug 7, 2023
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Nov 5, 2021 50%
Corporate OfficerPresident/Ceo Nov 5, 2021
John T Mitchell Individual Corporate OfficerVice President/Asst Secretary Nov 5, 2021
Frederick G Apt Individual Corporate OfficerVice President/Asst Treasurer Nov 5, 2021
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Gordon Arthur Glasgow Individual Contracted Managing EmployeeMD; Dec 1, 1988
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Nov 5, 2021 50%
Corporate OfficerVice President/Cfo/Secretary Nov 5, 2021

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 186

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

View all 186

Practitioners & affiliated clinicians

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1821027632",
    "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": "8382 NEWMAN AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477038",
            "telephone_number": "714-842-5551",
            "fax_number": "714-848-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS FIR HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "060000206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70171F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821027632",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05888H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntington Valley Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.