Rolla Grand LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ROLLA GRAND LLC

Practice address

1800 White Columns Dr
Rolla, MO 65401-2044

Phone

(314) 267-3725

NPI assigned

Aug 9, 2019

Last updated

Aug 9, 2019By 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

Greg Spence

Title

Owner

Phone

(636) 349-2311

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881249464. Details of each certification follow.

• CCN 265279 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265279

Legal name

ROLLA GRAND LLC

Doing business as

CEDAR POINTE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 3, 1985

Last certification

Jul 18, 2024

Beds

102

Ownership / control type

Partnership

Multi-facility organization

RILEY SPENCE PROPERTIES

Most recent change of ownership

Oct 1, 2019

Organization structure

LLCProprietary

Enrollment address

1800 White Columns Dr
Rolla, MO 65401-2044

Nursing home name

CEDAR POINTE

Affiliated entity

RILEY SPENCE SENIOR LIVING

Listed as

Cedar PointeCCN 265279 · All quality measures

Overall star rating

1 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 3, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10269.5 residents per day on average

Chain

Riley Spence Senior Living5 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 5

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.

• Marymount Manor LLC

  • Skilled Nursing Facility
  • Eureka, MO
  • NPI 1457412587

  Riley Spence Management Company, LLC

  CMS ownership
• Silverstone SNF LLC

  • Skilled Nursing Facility
  • Rolla, MO
  • NPI 1003224825

  Riley Spence Management Company, LLC

  CMS ownership
• The Woodlands of Maryland Heights LLC

  • Skilled Nursing Facility
  • Maryland Heights, MO
  • NPI 1487715793

  Riley Spence Management Company, LLC

  CMS ownership
• Woodland Manor of Arnold LLC

  • Skilled Nursing Facility
  • Arnold, MO
  • NPI 1245391507

  Riley Spence Management Company, LLC

  CMS ownership

Practitioners 1

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.

• Bohdan A Lebedowicz, MD

  • Internal Medicine Physician
  • Rolla, MO
  • NPI 1023087731
  NPD (past)

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1881249464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 GILSINN LN",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WHITE COLUMNS DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012044",
            "telephone_number": "314-267-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLA GRAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-349-2311"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Liane Robinson, M.D.
• Cathleen E Rodriguez, LPC
• Rolla Children's Clinic, P.C.
• Rolla Dermatology LLC
• Rolla Family Dentistry Inc
• Rolla Health Care LLC (Rolla Health & Rehabilitation Suites)
• Rolla Manor, Inc. (Rolla Manor Care Center)
• Rolla Neurology, Pain & Sleep, LLC
• Rolla Ophthalmology Associates, Inc
• Rolla Optical

• Skilled Nursing Facility in Rolla, MO
• Providers in Rolla, 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 Aug 9, 2019; 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.