Active NPI
Riverwood Center, LLC
- Skilled Nursing Facility
- Jacksonville, FL
National Provider Identifier
1871581801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- SNF1131095
- Legal business name
- RIVERWOOD CENTER, LLC
- Doing business as
- Riverwood Center
- Practice address
- 2802 Parental Home Rd
Jacksonville, FL 32216-5702 - Phone
- (904) 721-0088
- Fax
- (904) 724-7370
- NPI assigned
- Oct 13, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Monica Terrano
- Title
- Chief Financial Officer
- Phone
- (718) 852-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF1131095 | FL | Primary |
Addresses
Primary practice location
2802 Parental Home Rd
Jacksonville, FL 32216-5702
Mailing address
2802 Parental Home Rd
Jacksonville, FL 32216-5702
Phone (904) 721-0088
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C105135 | Other | FL | UNITED AMERICAN |
| 0004427159 | Other | FL | TRICARE |
| 026067300 | Medicaid | FL | |
| N74 | Other | FL | BLUE CROSS BLUE SHIELD |
Other names 1
- Riverwood Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030408000014 | FL | Part A Provider - Skilled Nursing Facility | 0143139188 | Practice locations: Jacksonville, FL |
Skilled nursing facility certification: CCN 105135
- Legal name
- RIVERWOOD CENTER LLC
- Doing business as
- RIVERWOOD CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 20, 1967
- Last certification
- Jan 9, 2025
- Beds
- 240
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Aston Health
- Organization structure
- LLC
- Incorporated
- Dec 19, 2002 in FL
- Enrollment address
- 2802 Parental Home Rd
Jacksonville, FL 32216-5702 - Nursing home name
- RIVERWOOD CENTER
- Affiliated entity
- ASTON HEALTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Riverwood Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 20, 1967
- Medicare certification status
- Active
- Certified beds
- 240
- Chain
- Aston Health
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0665469 | Riverwood Center,the | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
2808 Parental Home Rd
Jacksonville, FL 32216
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Ownership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Samuel Klein | 5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 75% |
| Gabriel Living Center, LLC | 5% Or Greater Direct Ownership Interest | Apr 1, 2003 | 100% |
| Gregory Kalmus | W-2 Managing Employee | Jul 21, 2020 | |
| Lce Partners LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 100% |
| Samuel Gutman | 5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 25% |
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Ormond Beach, FL
- NPI 1821086091
Gabriel Living Center, LLC
-
- Skilled Nursing Facility
- Ormond Beach, FL
- NPI 1760470785
Gabriel Living Center, LLC
-
- Skilled Nursing Facility
- Eustis, FL
- NPI 1275521213
Gabriel Living Center, LLC, Lce Partners LLC
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": "1129161600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708992000000",
"number": "1871581801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2802 PARENTAL HOME RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322165702",
"telephone_number": "904-721-0088",
"fax_number": "904-724-7370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 PARENTAL HOME RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322165702",
"telephone_number": "904-721-0088",
"fax_number": "904-724-7370"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIVERWOOD CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-13",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A",
"authorized_official_last_name": "TERRANO",
"authorized_official_first_name": "MONICA",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "718-852-7000",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": "SNF1131095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED AMERICAN",
"identifier": "C105135",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "0004427159",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "026067300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "N74",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Riverwood Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.