Adamsville Operating Group LLC
Organization Active NPI Skilled Nursing Facility · Adamsville, TN
NPI 1871156083 · NPPES record last updated Apr 15, 2019
Key facts
- NPI
- 1871156083
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- ADAMSVILLE OPERATING GROUP LLC
- Practice address
- 409 Park Ave
Adamsville, TN 38310-2461 - Phone
- (731) 632-3301
- NPI assigned
- Apr 15, 2019
- Organization subpart
- No
Authorized official
- Name
- Anshel Niederman
- Title
- Manager
- Phone
- (929) 900-2005
Owners & managing parties with NPI records 1
-
Nicholas Treece, D.O.
Facilities with the same owner 5
Practitioners 2
-
Nicholas Treece, D.O.
Affiliated clinicians 2
-
Nicholas Treece, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Adamsville Healthcare and Rehabilitation Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 16, 1997
- Medicare certification status
- Active
- Certified beds
- 125 · 79.4 residents per day on average
- Chain
- Ahava Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Skilled nursing facility certification: CCN 445397
- Legal name
- ADAMSVILLE OPERATING GROUP LLC
- Doing business as
- ADAMSVILLE HEALTHCARE AND REHABILITATIO CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 16, 1997
- Last certification
- Aug 4, 2021
- Beds
- 125
- Ownership / control type
- Corporation
- Multi-facility organization
- Ahava Healthcare
- Organization structure
- LLC · Proprietary
- Enrollment address
- 409 Park Ave
Adamsville, TN 38310-2461 - Nursing home name
- ADAMSVILLE HEALTHCARE AND REHABILITATION CENTER
- Affiliated entity
- AHAVA HEALTHCARE
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Benjamin Neuman |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Ecm Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| |
Adp of the SNF | Mar 18, 2025 | |
| |
Adp of the SNF | Mar 18, 2025 | |
| BDV Inv Holdco, LLC |
5% Or Greater Indirect Ownership Interest | Nov 26, 2004 | 20% |
| |
Adp of the SNF | Mar 21, 2025 | |
| Shiya Labin |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Anshel Niederman |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 50% |
| Corporate Officer | Jun 1, 2019 | ||
| Managing Control - Governing Body |
Jun 1, 2019 | ||
| Jack Cody Hardin |
Operational/Managerial Control | Feb 15, 2023 | |
| Adp of the SNF | Mar 21, 2025 | ||
| Nicholas L Treece |
Operational/Managerial Control | Oct 21, 2022 | |
| Adp of the SNF | Mar 21, 2025 | ||
| Adamsville Holdco LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2019 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190823001341 | TN | Part a Provider - Skilled Nursing Facility | 5092043331 | Practice locations: Adamsville, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
409 Park Ave
Adamsville, TN 38310-2461
Mailing address
544 Park Ave Ste B04
Brooklyn, NY 11205-1670
Phone (929) 900-2005
Other providers in Adamsville, TN
- Acute Care of Adamsville
- Adamsville Family Pharmacy
- Adamsville Healthcare LLC
- Adamsville Healthcare LLC
- Valerie Ann Alexander X
- Aristorenas Health Clinic
- Juan Tan Aristorenas Jr.
- Valerie R Barber
- Barnes Family Chiropractic Center, LLC
All providers in Adamsville, TN · Skilled Nursing Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2019. 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.