NPIMap

Organization Active NPI

Des Moines Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • West Des Moines, IA
National Provider Identifier
1861106924
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DES MOINES SKILLED NURSING FACILITY LLC
Practice address
5010 Grand Ridge Dr
West Des Moines, IA 50265-5754
Phone
(515) 222-5991
NPI assigned
Jan 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Chaim Rajchenbach
Title
Principal
Phone
(847) 676-5331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5010 Grand Ridge Dr
West Des Moines, IA 50265-5754

Mailing address

3450 Oakton St
Skokie, IL 60076-2951

Other names 1

  • Harmony West Des Moines Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230628002838 IA Part A Provider - Skilled Nursing Facility 0648639336 Practice locations: West Des Moines, IA

Skilled nursing facility certification: CCN 165601

Legal name
DES MOINES SKILLED NURSING FACILITY LLC
Doing business as
HARMONY WEST DES MOINES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 15, 2010
Last certification
Feb 20, 2025
Beds
113
Ownership / control type
Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Incorporated
Dec 13, 2022 in IA
Enrollment address
5010 Grand Ridge Dr
West Des Moines, IA 50265-5754
Nursing home name
HARMONY WEST DES MOINES
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Harmony West Des MoinesCCN 165601
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 15, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
113101.7 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Penalties (3 years)
1Fines totaling $0

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
16D1060608Harmony West Des Moines5010 Grand Ridge Drive, West Des Moines, IA 50265Certificate of waiverOct 26, 2026

National Provider Directory

National Provider Directory

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
Sammarra Smith Individual W-2 Managing EmployeeAdministrator Apr 1, 2023
Menachem Shabat Individual Corporate OfficerPresident Apr 1, 2023
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Apr 1, 2023 59.5%
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, Management services company, For-profit Operational/Managerial Control Apr 1, 2023
Oakway Operations LLC Organization, Skokie, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Apr 1, 2023 15%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Apr 1, 2023 25.5%

Facilities with the same owner 89

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

View all 89

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1861106924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 GRAND RIDGE DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655754",
            "telephone_number": "515-222-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES MOINES SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-676-5331"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harmony West Des Moines",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harmony West Des Moines",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.