NPIMap

Organization Active NPI

Pineville Healthcare LLC

  • Skilled Nursing Facility
  • Pineville, NC
National Provider Identifier
1922456664
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PINEVILLE HEALTHCARE LLC
Practice address
1010 Lakeview Dr
Pineville, NC 28134-7567
Phone
(704) 889-2273
Fax
(704) 889-5434
NPI assigned
Jun 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Mr. Jacob S. Stern
Title
Manager
Phone
(732) 659-1353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1010 Lakeview Dr
Pineville, NC 28134-7567

Mailing address

100 Route 70 Ste 3
Lakewood, NJ 08701-7406
Phone (732) 659-1353

Other names 1

  • Pineville Rehabilitation and Living Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160826000263 NC Part A Provider - Skilled Nursing Facility 0648565879 Practice locations: Pineville, NC

Skilled nursing facility certification: CCN 345415

Legal name
PINEVILLE HEALTHCARE LLC
Doing business as
PINEVILLE REHABILITATION AND LIVING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 2, 1992
Last certification
Jun 6, 2025
Beds
116 (106 certified)
Ownership / control type
Limited Liability Corporation
Multi-facility organization
CCH Healthcare
Organization structure
LLCProprietary
Incorporated
Feb 24, 2016 in DE
Enrollment address
1010 Lakeview Drive
Pineville, NC 28134
Nursing home name
PINEVILLE REHABILITATION AND LIVING CENTER
Affiliated entity
CCH HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pineville Rehabilitation and Living CenterCCN 345415
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 2, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10697.5 residents per day on average
Chain
CCH Healthcare33 facilities in the chain
Penalties (3 years)
2Fines totaling $15,470

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Pineville Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Capital Holdings Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Dec 29, 2022 35%
Starlight Healthcare LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest Dec 29, 2022 37.5%
10-26 Nationwide TR Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Dec 29, 2022 37.5%
Cassandra Dority Individual W-2 Managing EmployeeAdministrator Dec 29, 2022 100%
Operational/Managerial ControlAdministrator of Pineville Rehab Aug 3, 2015 100%
NCNH Holdings LLC Organization, Lakewood, NJ LLC, Holding company 5% Or Greater Direct Ownership Interest Dec 29, 2022 100%
Jacob Stern Individual Corporate OfficerManager Dec 29, 2022 100%
Corporate DirectorManager Dec 29, 2022 100%
NCNH J-Dek LLC Organization, Solon, OH LLC 5% Or Greater Indirect Ownership Interest Dec 29, 2022 25%
NC Resources LLC Organization, Cedarhurst, NY LLC 5% Or Greater Indirect Ownership Interest Dec 29, 2022 13%
NCNH J-Dek Holdings LLC Organization, Solon, OH LLC, Holding company 5% Or Greater Indirect Ownership Interest Dec 29, 2022 5%

Facilities with the same owner 55

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

View all 55

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": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1922456664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 70 STE 3",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017406",
            "telephone_number": "732-659-1353",
            "fax_number": "866-306-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKEVIEW DR",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281347567",
            "telephone_number": "704-889-2273",
            "fax_number": "704-889-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEVILLE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-659-1353",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pineville Rehabilitation and Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, NC

Sources for this page

Verify at the official NPI Registry.