NPIMap

Organization Active NPI

Arrowhead SD Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Rapid City, SD
National Provider Identifier
1881250397
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ARROWHEAD SD SKILLED NURSING FACILITY LLC
Practice address
2500 Arrowhead Dr
Rapid City, SD 57702-4225
Phone
(605) 348-0285
Fax
(605) 343-5771
NPI assigned
May 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Authorized official

Name
Chaim Rajchenbach
Title
Ceo/Principal
Phone
(847) 679-9797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2500 Arrowhead Dr
Rapid City, SD 57702-4225

Mailing address

3450 Oakton St
Skokie, IL 60076-2951
Phone (847) 679-9797

Other names 1

  • Avantara Arrowhead Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190828003995 SD Part A Provider - Skilled Nursing Facility 9032447099 Practice locations: Rapid City, SD

Skilled nursing facility certification: CCN 435051

Legal name
ARROWHEAD SD SKILLED NURSING FACILITY LLC
Doing business as
AVANTARA ARROWHEAD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1991
Last certification
May 15, 2024
Beds
68
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Enrollment address
2500 Arrowhead Dr
Rapid City, SD 57702-4225
Nursing home name
AVANTARA ARROWHEAD
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avantara ArrowheadCCN 435051
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6859.3 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
6Fines totaling $153,583

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D2168189Avantara Arrowhead2500 Arrowhead Dr, Rapid City, SD 57702Certificate of waiverJun 23, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Arrowhead SD Property Holdings, LLC Organization, Skokie, IL LLC 5% Or Greater Security Interest Jul 1, 2019 100%
Adp of the SNF Jul 1, 2019
Sharon Martin Individual Operational/Managerial Control Apr 9, 2023
Adp of the SNF Apr 9, 2023
Menachem Shabat Individual Operational/Managerial Control Jul 1, 2019
Managing Control - Governing BodyManager of the Manager Jul 1, 2019
Adp of the SNF Jul 1, 2019
Chaim Rajchenbach Individual Operational/Managerial Control Jul 1, 2019
Managing Control - Governing BodyManager of the Manager Jul 1, 2019
Adp of the SNF Jul 1, 2019
Individual Indirect Ownership Interest Jul 1, 2019 4.9%
Travis Ptacek Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jul 1, 2019 42.5%
Adp of the SNF Jul 1, 2019
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, For-profit Operational/Managerial Control Jul 1, 2019
Adp of the SNF Nov 10, 2025
Individual Indirect Ownership Interest Jul 1, 2019 2.6%
Oakway Operations LLC Organization, Skokie, IL LLC 5% Or Greater Direct Ownership Interest Jul 1, 2019 15%
RSM US LLP Organization, Davenport, IA Consulting firm Adp of the SNF Jan 1, 2024
Individual Indirect Ownership Interest Jul 1, 2019 4.9%
Truist Bank Organization, Charlotte, NC Financial institution 5% Or Greater Security Interest Apr 1, 2022 100%
Operational/Managerial Control Apr 1, 2022
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jul 1, 2019 42.5%
Adp of the SNF Jul 1, 2019
Individual Indirect Ownership Interest Jul 1, 2019 2.6%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 89

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

View all 89

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1881250397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797",
            "fax_number": "847-679-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ARROWHEAD DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577024225",
            "telephone_number": "605-348-0285",
            "fax_number": "605-343-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROWHEAD SD SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "CEO/PRINCIPAL",
        "authorized_official_telephone_number": "847-679-9797"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avantara Arrowhead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.