Organization Active NPI

Park Anaheim Health Care, LLC

  • Skilled Nursing Facility
  • Anaheim, CA
National Provider Identifier
1851460240
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
060000094 Issued in CA
Legal business name
PARK ANAHEIM HEALTH CARE, LLC
Doing business as
PARK ANAHEIM HEALTHCARE CENTER
Practice address
3435 W Ball Rd
Anaheim, CA 92804-3708
Phone
(714) 827-5880
Fax
(714) 827-8815
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Authorized official

Name
David Friedman
Title
Managing Member
Phone
(213) 389-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 060000094 CA Primary

Addresses

Primary practice location

3435 W Ball Rd
Anaheim, CA 92804-3708

Mailing address

4032 Wilshire Blvd FL 6
Los Angeles, CA 90010-3425
Phone (213) 389-6900

Other identifiers 2

IdentifierTypeStateIssuer
LTC55035GMedicaidCA
LTC70120FMedicaidCA

Other names 1

  • PARK ANAHEIM HEALTHCARE CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070716000564 CA Part A Provider - Skilled Nursing Facility 1052411329 Practice locations: Anaheim, CA
O20110524000109 CA Part B Supplier - Clinic/Group Practice 5294911442 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anaheim, CA; Seal Beach, CA; Laguna Hills, CA; Garden Grove, CA; Bellflower, CA

Skilled nursing facility certification: CCN 555035

Legal name
PARK ANAHEIM HEALTH CARE, LLC
Doing business as
PARK ANAHEIM HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 23, 1976
Last certification
Mar 14, 2025
Beds
115
Ownership / control type
Corporation
Organization structure
LLCProprietary
Enrollment address
3435 W Ball Rd
Anaheim, CA 92804-3708
Nursing home name
PARK ANAHEIM HEALTHCARE CENTER
Affiliated entity
LONGWOOD MANAGEMENT CORPORATION

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Park Anaheim Healthcare CenterCCN 555035 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 23, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
115106.5 residents per day on average
Chain
Longwood Management Corporation38 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
05D0885673Park Anaheim Healthcare Center3435 W Ball Rd, Anaheim, CA 92804Certificate of waiverApr 27, 2028

National Provider Directory

National Provider Directory

Locations

3455 W Ball Rd
Anaheim, CA 92804

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Aaron Friedman Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 20%
Trustee of the SNF Jun 30, 2023
Adp of the SNF Jun 30, 2023
Organization, Chicago, IL LLC, For-profit Adp of the SNF Jun 30, 2023
Libby Lehmann Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 20%
Trustee of the SNF Jun 30, 2023
Rachel Klavan Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 20%
Trustee of the SNF Jun 30, 2023
Organization, Chicago, IL LLC, For-profit Adp of the SNF Jun 30, 2023
Fariborz Shams Individual Operational/Managerial Control Jun 9, 2024
Adp of the SNF Jun 9, 2024
Lehmann Family 1991 Trust Organization, Los Angeles, CA For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Marissa Bansal Individual Operational/Managerial Control Apr 4, 2018
Adp of the SNF Apr 4, 2018
The Klavan Family Trust Organization, Los Angeles, CA For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Organization, Los Angeles, CA For-profit Adp of the SNF Jun 30, 2023
Joshua Klavan Individual Operational/Managerial Control Dec 1, 2022
Adp of the SNF Nov 16, 1986
Organization, Portland, OR LLC, For-profit Adp of the SNF Jun 30, 2023
Organization, Portland, OR Corporation, LLC, For-profit Adp of the SNF Jun 30, 2023
Organization, Portland, OR LLC, For-profit Adp of the SNF Jun 30, 2023
Longwood Management LLC Organization, Los Angeles, CA LLC, For-profit, Chain home office Adp of the SNF Jan 1, 2023
Organization, Portland, OR LLC, For-profit Adp of the SNF Jun 30, 2023
Individual Adp of the SNF Jun 30, 2023
The Tzippy Friedman Notis 1990 Trust Organization, Los Angeles, CA For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Organization, Portland, OR LLC, Consulting firm, For-profit Adp of the SNF Jun 30, 2023
Ira D Friedman 1991 Trust Organization, Los Angeles, CA For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Friedman Family Trust Organization, Los Angeles, CA For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Caroline Bruso Individual Operational/Managerial Control Feb 16, 2022
Adp of the SNF Feb 16, 2022
Organization, Portland, OR LLC, For-profit Adp of the SNF Jun 30, 2023
Ira David Friedman Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 20%
Corporate OfficerManager Apr 1, 1995 20%
Operational/Managerial Control Jun 30, 2023
Managing Control - Governing BodyPresident Jun 30, 2023
Trustee of the SNF Jun 30, 2023
Adp of the SNF Jun 30, 2023
Zaid Pervaiz Individual Adp of the SNF Jan 1, 2013

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 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 6

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1851460240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 WILSHIRE BLVD FL 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103425",
            "telephone_number": "213-389-6900",
            "fax_number": "213-368-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043708",
            "telephone_number": "714-827-5880",
            "fax_number": "714-827-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK ANAHEIM HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "213-389-6900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "060000094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55035G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70120F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK ANAHEIM HEALTHCARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PARK ANAHEIM HEALTHCARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.