Organization Active NPI

Glenhaven Healthcare, LLC

  • Skilled Nursing Facility
  • Glendale, CA
National Provider Identifier
1831574243
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GLENHAVEN HEALTHCARE, LLC
Practice address
212 W Chevy Chase Dr
Glendale, CA 91204-2318
Phone
(818) 240-6720
Fax
(818) 247-3942
NPI assigned
Jul 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Matthew S Karp
Title
Manager
Phone
(213) 484-0784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

212 W Chevy Chase Dr
Glendale, CA 91204-2318

Mailing address

212 W Chevy Chase Dr
Glendale, CA 91204-2318
Phone (626) 314-3604

Other names 1

  • GlenHaven Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161006000170 CA Part A Provider - Skilled Nursing Facility 4587971353 Practice locations: Glendale, CA

Skilled nursing facility certification: CCN 555605

Legal name
GLENHAVEN HEALTHCARE LLC
Doing business as
GLENHAVEN HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 24, 1994
Last certification
Nov 21, 2024
Beds
52
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jul 14, 2015 in CA
Enrollment address
212 W Chevy Chase Dr
Glendale, CA 91204-2318
Nursing home name
GLENHAVEN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Glenhaven HealthcareCCN 555605
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 24, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5243.5 residents per day on average
Penalties (3 years)
1Fines totaling $18,070

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
05D0556802Glenhaven Healthcare212 W Chevy Chase Dr, Glendale, CA 91204Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Elms Convalescent Hospital2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3452 E Foothill Blvd
Ste 240
Pasadena, CA 91107

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Matthew S Karp Individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 50%
Operational/Managerial ControlManager Jun 30, 2023 100%
Marydes Guevarra Individual Operational/Managerial Control Apr 29, 2024
Adp of the SNF Mar 26, 2025
Abraham Bak Individual Adp of the SNF May 13, 2015
Benjamin M Karp Individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 50%
Corporate OfficerManager Aug 1, 2015 100%
Operational/Managerial Control Jun 30, 2023
Caravan Operations Corp Organization, Los Angeles, CA Corporation, Chain home office Adp of the SNF Sep 20, 2012
Garo M Karakashian Individual Operational/Managerial Control Mar 1, 2024
Adp of the SNF Mar 1, 2024

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1831574243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W CHEVY CHASE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042318",
            "telephone_number": "626-314-3604",
            "fax_number": "626-421-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W CHEVY CHASE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042318",
            "telephone_number": "818-240-6720",
            "fax_number": "818-247-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENHAVEN HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "KARP",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "213-484-0784"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GlenHaven Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.