Organization Active NPI

Casa Coloma Holdings, LLC

Doing business as Casa Coloma Health Care Center

  • Skilled Nursing Facility
  • Rancho Cordova, CA
National Provider Identifier
1891310520
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CASA COLOMA HOLDINGS, LLC
Doing business as
Casa Coloma Health Care Center
Practice address
10410 Coloma Rd
Rancho Cordova, CA 95670-2108
Phone
(916) 363-4843
NPI assigned
Jun 9, 2020
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Richard Martin
Title
Manager
Phone
(916) 363-4843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

10410 Coloma Rd
Rancho Cordova, CA 95670-2108

Mailing address

4747 Viewridge Ave Ste 105
San Diego, CA 92123-1688
Phone (916) 363-4843

Other names 1

  • Casa Coloma Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200827000744 CA Part A Provider - Skilled Nursing Facility 2365869922 Practice locations: Rancho Cordova, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891310520. Details of each certification follow.

Skilled nursing facility certification: CCN 056495

Legal name
CASA COLOMA HOLDINGS LLC
Doing business as
CASA COLOMA HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 19, 1975
Last certification
Jan 31, 2025
Beds
138
Ownership / control type
Limited Liability Corporation
Multi-facility organization
BVHC LLC
Organization structure
LLCProprietary
Incorporated
May 26, 2020 in CA
Enrollment address
10410 Coloma Rd
Rancho Cordova, CA 95670-2108
Nursing home name
CASA COLOMA HEALTH CARE CENTER
Affiliated entity
BVHC, LLC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Casa Coloma Health Care CenterCCN 056495 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 19, 1975
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
138131.7 residents per day on average
Chain
BVHC, LLC12 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

10410 Coloma Rd
Rncho Cordova, CA 95670
Phone (916) 363-4843

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Debbie Cubero Castaneda Individual Operational/Managerial Control Jul 14, 2021
Adp of the SNF Jul 14, 2021
BVHC, LLC Organization, San Diego, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2020 100%
Nischal Thapa Individual Operational/Managerial Control Aug 6, 2024
Adp of the SNF Aug 6, 2024
Michael D Jones Individual Operational/Managerial Control Jul 1, 2021
Adp of the SNF Jul 1, 2021
Redentor Batin Calabazaron Individual Operational/Managerial Control Aug 6, 2024
Adp of the SNF Aug 6, 2024
Jane Lata-Gokul Individual Operational/Managerial Control Apr 28, 2023
Adp of the SNF Apr 28, 2023
Dzmitry D Kazlou Individual Operational/Managerial Control Sep 1, 2021
Adp of the SNF Sep 1, 2021
Bryan Boehrer Individual Indirect Ownership Interest Jun 30, 2020 50%
Ravi Chinthakindi Individual Operational/Managerial Control Jan 30, 2023
Adp of the SNF Jan 30, 2023
Tanner John Wilson Individual Operational/Managerial Control Oct 3, 2022
Adp of the SNF Oct 3, 2022
Richard Martin Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2020 50%
Operational/Managerial Control Jun 30, 2020
Adp of the SNF Jun 30, 2020
Teresita Bianan Abenojar Individual Operational/Managerial Control Aug 17, 2023
Adp of the SNF Aug 17, 2023

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 10

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

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": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1891310520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 VIEWRIDGE AVE STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231688",
            "telephone_number": "916-363-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 COLOMA RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702108",
            "telephone_number": "916-363-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA COLOMA HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-363-4843"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa Coloma Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.