Maple Grove Wellness & Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MAPLE GROVE WELLNESS & REHABILITATION LLC

Doing business as

Maple Grove Wellness & Rehabilitation

Practice address

560 Corisande Hill Rd
Fenton, MO 63026-5613

Phone

(636) 343-2282

NPI assigned

May 21, 2024

Last updated

Jul 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Garetz

Title

Cfo

Phone

(323) 987-5954

Specialties & licenses 1

Addresses

Other names 1

• Maple Grove Wellness & Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861231698. Details of each certification follow.

• CCN 265395 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265395

Legal name

MAPLE GROVE WELLNESS & REHABILITATION LLC

Doing business as

MAPLE GROVE WELLNESS & REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 24, 1989

Last certification

May 7, 2024

Beds

144

Ownership / control type

Corporation

Multi-facility organization

OPCO

Organization structure

LLCProprietary

Enrollment address

560 Corisande Hill Rd
Fenton, MO 63026-5613

Nursing home name

MAPLE GROVE WELLNESS & REHABILITATION

Affiliated entity

OPCO SKILLED MANAGEMENT

Listed as

Maple Grove Wellness & RehabilitationCCN 265395 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 24, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

14483.0 residents per day on average

Chain

Opco Skilled Management66 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 20

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

Facilities with the same owner 4

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

• Blooming Oaks Wellness & Rehabilitation LLC

  dba Bluebird Wellness & Rehabilitation

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1699528422

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership
• Blue Springs Wellness & Rehabilitation LLC

  dba Blue Springs Wellness & Rehabilitation

  • Skilled Nursing Facility
  • Blue Springs, MO
  • NPI 1639998479

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership
• Sage Nursing & Rehab LLC

  dba Magnolia Wellness Center

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1427897255

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership
• Willowcreek Wellness & Rehabilitation LLC

  dba Willowcreek Wellness & Rehabilitation

  • Skilled Nursing Facility
  • Florissant, MO
  • NPI 1780437517

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership

Practitioners 2

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.

• Iqbal Amin, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1184619835
  NPD (past)
• Patrick Joseph McCann, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1437275963
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Iqbal Amin, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1184619835

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720310400000",
    "number": "1861231698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 CORISANDE HILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630265613",
            "telephone_number": "636-343-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 CORISANDE HILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630265613",
            "telephone_number": "636-343-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE GROVE WELLNESS & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A",
        "authorized_official_last_name": "GARETZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "323-987-5954"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Grove Wellness & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maple Grove Wellness & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Luketich, RBT
• Carolyn Sue Lundgren, C.P.N.P.
• Luxottica of America Inc. (Target Optical #1968)
• Scott Michael Maddock, BSN, RN, CRNFA, CNOR
• Bassam Malo, M.D.
• Marcio Guzman
• Matea Markovic
• Ryan Markus
• Martin Family Dental, LLC
• Daryl John Martin, D.D.S.

• Skilled Nursing Facility in Fenton, MO
• Providers in Fenton, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.