Debary Manor Operations LLC
Organization Active NPI Skilled Nursing Facility · Debary, FL
NPI 1871105270 · NPPES record last updated Feb 27, 2024
Key facts
- NPI
- 1871105270
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- DEBARY MANOR OPERATIONS LLC
- Practice address
- 60 N Highway 17 92
Debary, FL 32713-2513 - Phone
- (386) 668-4426
- NPI assigned
- Aug 18, 2020
- Organization subpart
- No
Authorized official
- Name
- Mrs. Monica Terrano
- Title
- Chief Financial Officer
- Phone
- (718) 852-7000
Owners & managing parties with NPI records 1
-
Ram M Amilineni, M.D.
Facilities with the same owner 4
Affiliated clinicians 4
-
Ram M Amilineni, M.D.
-
Shrish Calla, MD
-
Radharani S. Gollamudi, M.D.
-
Angela R Merzenich, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Debary Health and Rehabilitation Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1985
- Certified beds
- 120 · 110.7 residents per day on average
- Chain
- Aston Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Skilled nursing facility certification: CCN 105514
- Legal name
- DEBARY MANOR OPERATIONS LLC
- Doing business as
- DEBARY HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1985
- Last certification
- Jan 19, 2024
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Aston Health
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 13, 2020 in DE
- Enrollment address
- 60 N Highway 17 92
Debary, FL 32713-2513 - Nursing home name
- DEBARY HEALTH AND REHABILITATION CENTER
- Affiliated entity
- ASTON HEALTH
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Leroy George Cox |
Operational/Managerial Control | Dec 18, 2023 | |
| Adp of the SNF | Jul 17, 2025 | ||
| Blue Spring Healthcare Partners LLC |
5% Or Greater Indirect Ownership Interest | Aug 13, 2020 | 100% |
| Kamran Manzur |
Operational/Managerial Control | Feb 17, 2025 | |
| Aston Healthcare LLC |
Adp of the SNF | Jan 1, 2022 | |
| Dawn M. Kenney |
Operational/Managerial Control | Nov 3, 2020 | |
| Ram M Amilineni |
Operational/Managerial Control | Nov 3, 2020 | |
| Adp of the SNF | Jul 17, 2025 | ||
| Donna Wildes |
Corporate Officer |
Aug 28, 2025 | |
| Operational/Managerial Control | Aug 28, 2025 | ||
| Adp of the SNF | Aug 28, 2025 | ||
| Samuel Gutman |
5% Or Greater Indirect Ownership Interest | Aug 13, 2020 | 20% |
| Indirect Ownership Interest | Aug 13, 2020 | 20% | |
| Leopold Friedman |
5% Or Greater Indirect Ownership Interest | Jan 1, 2026 | 80% |
| Indirect Ownership Interest | Jan 1, 2026 | 80% | |
| Debary Manor Operations Holdings LLC |
5% Or Greater Direct Ownership Interest | Aug 13, 2020 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201103003063 | FL | Part a Provider - Skilled Nursing Facility | 5193135044 | Practice locations: Debary, FL |
National Provider Directory
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
60 N Highway 17 92
Debary, FL 32713-2513
Mailing address
2123 Centre Pointe Blvd
Tallahassee, FL 32308-4930
Other providers in Debary, FL
- Elisa Davis
- Sharon A Day Osteen
- Debary Chiropractic Center Corp
- Debary Dentistry LLC
- Debary Family Practice
- Barbara Defazzio
- Michael Edward Degrood
- Nayadit Del Toro Benitez
- Delta Health Group Inc
- Deltona Counseling Associates, P.a.
All providers in Debary, FL · Skilled Nursing Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.