NPIMap

Organization Active NPI

Lime Ridge Healthcare, LLC

  • Skilled Nursing Facility
  • Concord, CA
National Provider Identifier
1902505746
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LIME RIDGE HEALTHCARE, LLC
Doing business as
Concord Post Acute
Practice address
1050 San Miguel Rd
Concord, CA 94518-2094
Phone
(925) 825-4280
NPI assigned
Mar 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1050 San Miguel Rd
Concord, CA 94518-2094

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Concord Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230912003763 CA Part A Provider - Skilled Nursing Facility 7618331406 Practice locations: Concord, CA

Skilled nursing facility certification: CCN 555104

Legal name
LIME RIDGE HEALTHCARE LLC
Doing business as
CONCORD POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 15, 1979
Last certification
Nov 16, 2023
Beds
190
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
May 1, 2020 in CA
Enrollment address
1050 San Miguel Rd
Concord, CA 94518-2094
Nursing home name
CONCORD POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Concord Post AcuteCCN 555104 · 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
Feb 15, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
190188.0 residents per day on average
Chain
Pacs Group274 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $30,820

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
05D0597627Concord Post Acute1050 San Miguel Rd, Concord, CA 94518Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1050 San Miguel Rd
Concord, CA 94518
Phone (915) 825-4280

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Vasili Dzerhachou Individual Contracted Managing EmployeeMD; Nov 28, 2022
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Forrest Allen Individual W-2 Managing EmployeeAdministrator Nov 30, 2022
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

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 186

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

View all 186

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1902505746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SAN MIGUEL RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945182094",
            "telephone_number": "925-825-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIME RIDGE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concord Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.