Organization Active NPI

Piney Forest SNF LLC

  • Skilled Nursing Facility
  • Danville, VA
National Provider Identifier
1881268050
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PINEY FOREST SNF LLC
Doing business as
Piney Forest Health & Rehabilitation Center
Practice address
450 Piney Forest Rd
Danville, VA 24540-4011
Phone
(434) 799-1565
NPI assigned
May 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Kyle Swim
Title
Administrator
Phone
(434) 799-1565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

450 Piney Forest Rd
Danville, VA 24540-4011

Mailing address

450 Piney Forest Rd
Danville, VA 24540-4011

Other names 1

  • Piney Forest Health & Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210823003250 VA Part A Provider - Skilled Nursing Facility 8729483102 Practice locations: Danville, VA

Skilled nursing facility certification: CCN 495107

Legal name
PINEY FOREST SNF LLC
Doing business as
PINEY FOREST HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home โ€“ SNF/NF dual certification
Participating since
Jan 1, 1978
Last certification
Jan 30, 2025
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Medical Facilities of America
Most recent change of ownership
May 28, 2021
Organization structure
LLCProprietary
Enrollment address
450 Piney Forest Rd
Danville, VA 24540-4011
Nursing home name
PINEY FOREST HEALTH AND REHABILITATION CENTER
Affiliated entity
LIFEWORKS REHAB

Care Compare: Nursing home

Medicare Care Compare
Listed as
Piney Forest Health and Rehabilitation CenterCCN 495107 ยท All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120115.9 residents per day on average
Chain
Lifeworks Rehab64 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Lauren 2020 LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 23.75%
Springrock South LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 75%
Norman 5571 & Family LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 23.75%
RL 2008 Family Trust Organization, Miami, FL 5% Or Greater Indirect Ownership Interest May 28, 2021 10%
Charles 1994 Family Grantor Trust Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 21.37%
Lauren 2020 Family Grantor Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest May 28, 2021 22.56%
Piney Forest Holdings I LLC Organization, Lakewood, NJ LLC 5% Or Greater Direct Ownership Interest May 28, 2021 100%
Rsbrm South Manager LLC Organization, Lakewood, NJ LLC Operational/Managerial Control May 28, 2021 100%
Norman 5571 Family Grantor Trust Organization, Cleveland, OH 5% Or Greater Indirect Ownership Interest May 28, 2021 21.37%
Norman 5571 LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 22.49%
Saul 2012 Family Grantor Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest May 28, 2021 22.56%
Leps 2003 Family Trust Organization, Miami, FL 5% Or Greater Indirect Ownership Interest May 28, 2021 10%
Amber K Tejeda Individual Corporate Officer Jan 23, 2024
W-2 Managing Employee Jan 23, 2024
DRM South LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 25%
Robin 2008 LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 23.75%
CK 2008 Family Trust Organization, Miami, FL 5% Or Greater Indirect Ownership Interest May 28, 2021 5%
Edward 1998 Family Grantor Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest May 28, 2021 22.56%
Robin 2008 Family Grantor Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest May 28, 2021 22.56%
Summer South LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest May 28, 2021 100%

Facilities with the same owner 37

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

View all 37

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1881268050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404011",
            "telephone_number": "434-799-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEY FOREST SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "SWIM",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "434-799-1565"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piney Forest Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.