NPIMap

Organization Active NPI

Latham River Healthcare, Inc.

Doing business as Westlake Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Greeley, CO
National Provider Identifier
1841033032
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LATHAM RIVER HEALTHCARE, INC.
Doing business as
Westlake Health and Rehabilitation Center
Practice address
1637 29TH Avenue PL
Greeley, CO 80634-6822
Phone
(970) 356-8181
NPI assigned
Jun 14, 2024
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1637 29TH Avenue PL
Greeley, CO 80634-6822

Mailing address

1637 29TH Avenue PL
Greeley, CO 80634-6822

Other names 1

  • Westlake Health and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240920001506 CO Part A Provider - Skilled Nursing Facility 8325589062 Practice locations: Greeley, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841033032. Details of each certification follow.

Skilled nursing facility certification: CCN 065212

Legal name
LATHAM RIVER HEALTHCARE, INC.
Doing business as
WESTLAKE HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1985
Last certification
Apr 11, 2024
Beds
107
Ownership / control type
Corporation
Multi-facility organization
Vivage Beecan
Most recent change of ownership
Sep 1, 2024
Organization structure
CorporationProprietary
Incorporated
May 24, 2024 in NV
Enrollment address
1637 29TH Avenue PL
Greeley, CO 80634-6822
Nursing home name
WESTLAKE HEALTH AND REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Westlake Health and Rehabilitation CenterCCN 065212 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10790.0 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
1Fines totaling $14,069

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Latham River Healthcare Inc2 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

1637 29th Avenue Pl
Greeley, CO 80634
Phone (970) 330-6400

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Nursa Inc Organization, Dallas, TX Corporation Operational/Managerial Control Sep 1, 2024
Malcolm R Fraser Individual Operational/Managerial Control Sep 1, 2024
Managing Control - Governing BodyMedical Director Sep 1, 2024
Adp of the SNF Jun 21, 2025
Onshift Inc Organization, Dallas, TX Corporation Operational/Managerial Control Sep 1, 2024
Joseph Graham Individual Corporate OfficerPresident Latham River Healthcare May 24, 2024
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest May 24, 2024 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Sep 1, 2024
Ami Sato Individual Corporate OfficerTreasurer Latham River Healthcare Sep 9, 2024
Endura Healthcare LLC Organization, San Juan Capistrano, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 24, 2024 100%
David Jorgensen Individual Corporate DirectorDirector Latham River Healthcare May 24, 2024
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
SMV Greeley Centennial LLC Organization, New York, NY LLC Adp of the SNF Sep 1, 2025
Calvin Conley Individual Operational/Managerial Control Apr 1, 2025
Managing Control - Governing BodyAdministrator Apr 1, 2025
Adp of the SNF Jun 21, 2025
Soon Burnam Individual Corporate OfficerSecretary Latham River Healthcare May 24, 2024

Facilities with the same owner 43

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

View all 43

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 2

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": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1841033032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 29TH AVENUE PL",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 29TH AVENUE PL",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346822",
            "telephone_number": "970-356-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATHAM RIVER HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westlake Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.