Highland Healthcare Camellia Gardens, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HIGHLAND HEALTHCARE CAMELLIA GARDENS, LLC

Doing business as

Highland Healthcare Camellia Gardens, LLC

Practice address

1920 N Fair Oaks Ave
Pasadena, CA 91103-1623

Phone

(626) 798-7742

NPI assigned

Oct 16, 2019

Last updated

Oct 16, 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

Samuel Chazanow

Title

Assistant

Phone

(323) 456-6399

Specialties & licenses 1

Addresses

Other names 1

• Highland Healthcare Camellia Gardens, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891337234. Details of each certification follow.

• CCN 056316 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 056316

Legal name

HIGHLAND HEALTHCARE CAMELLIA GARDENS, LLC

Doing business as

CAMELLIA GARDENS CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1974

Last certification

Mar 7, 2025

Beds

80

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

1920 N Fair Oaks Ave
Pasadena, CA 91103-1623

Nursing home name

CAMELLIA GARDENS CARE CENTER

Listed as

Camellia Gardens Care CenterCCN 056316 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 1, 1974

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8073.0 residents per day on average

Penalties (3 years)

1Fines totaling $1,747

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

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

• Donald Balacuit, DO

  • Family Medicine Physician
  • Monrovia, CA
  • NPI 1598737116

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Donald Balacuit, DO

  • Family Medicine Physician
  • Monrovia, CA
  • NPI 1598737116

  Nursing home

  Care Compare affiliation
• Marina E Manvelyan, MD

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1215925409

  Nursing home

  Care Compare affiliation
• Stan Mathioulakis, MD

  • Internal Medicine Physician
  • Duarte, CA
  • NPI 1912080847

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1891337234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N LARCHMONT BLVD STE 409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 N FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031623",
            "telephone_number": "626-798-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND HEALTHCARE CAMELLIA GARDENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "CHAZANOW",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "323-456-6399"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Healthcare Camellia Gardens, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Analy Hidalgo
• Anthony Hidalgo, RT
• Marleena Higgins
• Michael T Higgins, MD
• David Highfill, LCSW, MSW
• Daisy Highley
• Catherine Anne Hight, RN
• Erica A. Hightower
• Cassidy Mariah Higley, BA
• Justina Hii, PHARMD

• Skilled Nursing Facility in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.