Active NPI
Bellflower Skilled LLC
- Skilled Nursing Facility
- Bellflower, CA
National Provider Identifier
1902531403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- BELLFLOWER SKILLED LLC
- Practice address
- 16910 Woodruff Ave
Bellflower, CA 90706-6036 - Phone
- (562) 867-1761
- NPI assigned
- Jul 19, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Johnson
- Title
- Ceo
- Phone
- (714) 577-3880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
16910 Woodruff Ave
Bellflower, CA 90706-6036
Mailing address
16910 Woodruff Ave
Bellflower, CA 90706-6036
Phone (562) 867-1761
Other names 1
- Villa Del Sol Post Acute
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221024001324 | CA | Part A Provider - Skilled Nursing Facility | 5294101895 | Practice locations: Bellflower, CA |
Skilled nursing facility certification: CCN 055918
- Legal name
- BELLFLOWER SKILLED LLC
- Doing business as
- VILLA DEL SOL POST ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1985
- Last certification
- Apr 4, 2025
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Apr 1, 2022 in CA
- Enrollment address
- 16910 Woodruff Ave
Bellflower, CA 90706-6036 - Nursing home name
- VILLA DEL SOL POST ACUTE
- Affiliated entity
- DAVID JOHNSON
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Villa del Sol Post Acute
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 1, 1985
- Medicare certification status
- Active
- Certified beds
- 99
- Chain
- David Johnson
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0888855 | Villa del Sol Post Acute | Certificate of waiver | Jul 13, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David a Johnson | 5% Or Greater Indirect Ownership Interest | Aug 16, 2022 | 50% |
| Other | Aug 16, 2022 | ||
| Frank a Johnson | 5% Or Greater Mortgage Interest | Aug 16, 2022 | |
| Other | Aug 16, 2022 | ||
| Bradley B Powell | W-2 Managing Employee | Dec 1, 2021 | |
| Bellflower Skilled LLC | 5% Or Greater Direct Ownership Interest | Aug 16, 2022 | |
| Adrian Dehghanmanesh | Corporate Officer | Aug 16, 2022 |
Practitioners & affiliated clinicians
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Long Beach, CA
- NPI 1982627956
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658188800000",
"number": "1902531403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16910 WOODRUFF AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907066036",
"telephone_number": "562-867-1761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16910 WOODRUFF AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907066036",
"telephone_number": "562-867-1761"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BELLFLOWER SKILLED LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "714-577-3880"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Villa Del Sol Post Acute",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bellflower, CA
- Bell Villa Care Associates LLC
- Bellflower Gateway Modern Dentistry, Inc.
- Bellflower Health and Wellness Center Inc
- Bellflower Health Clinic, LLC
- Bellflower Post Acute LLC
- Bellflower Unified School District
- Bellwood Medical Center Pharmacy Corp
- Bellwood Medical Center Pharmacy Corp
- Bellwood Physical Therapy Inc
- Bellwood PT Incorporated
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.