NPIMap

Organization Active NPI

Contra Loma Healthcare, LLC

Doing business as Lone Tree Post Acute

  • Skilled Nursing Facility
  • Antioch, CA
National Provider Identifier
1821613803
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CONTRA LOMA HEALTHCARE, LLC
Doing business as
Lone Tree Post Acute
Practice address
4001 Lone Tree Way
Antioch, CA 94509-6232
Phone
(925) 754-0470
NPI assigned
Jun 15, 2020
Last updated
Aug 19, 2024By the provider in NPPES
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
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4001 Lone Tree Way
Antioch, CA 94509-6232

Mailing address

140 N Union Ave Ste 320
Farmington, UT 84025-2956

Other names 1

  • Lone Tree 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
O20201005001392 CA Part A Provider - Skilled Nursing Facility 8921427311 Practice locations: Antioch, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821613803. Details of each certification follow.

Skilled nursing facility certification: CCN 056021

Legal name
CONTRA LOMA HEALTHCARE, LLC
Doing business as
LONE TREE POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 7, 1979
Last certification
Dec 6, 2023
Beds
99
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Contra Loma Healthcare, LLC.
Organization structure
LLCProprietary
Incorporated
May 1, 2020 in CA
Enrollment address
4001 Lone Tree Way
Antioch, CA 94509-6232
Nursing home name
LONE TREE POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lone Tree Post AcuteCCN 056021 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 7, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9994.9 residents per day on average
Chain
Pacs Group274 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
05D0719350Lone Tree Post Acute4001 Lone Tree Way, Antioch, CA 94509Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

4001 Lone Tree Way
Antioch, CA 94509
Phone (925) 754-0470

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
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2020 50%
Corporate OfficerPresident/Ceo May 1, 2020
John T Mitchell Individual Corporate OfficerVice President/Asst Secretary Feb 10, 2021
Frederick G Apt Individual Corporate OfficerVice President/Asst Treasurer Feb 10, 2021
Matthew Hadley Individual W-2 Managing EmployeeAd; May 1, 2023
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
Gurpreet Dhugga Individual Contracted Managing EmployeeMD; Jan 1, 2015
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2020 50%
Corporate OfficerVice President/Cfo/Secretary May 1, 2020

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 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": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1821613803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N UNION AVE STE 320",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096232",
            "telephone_number": "925-754-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTRA LOMA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "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"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Tree Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lone Tree Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.