Clovis Skilled Care LLC
Organization Active NPI Skilled Nursing Facility · Clovis, CA
NPI 1952014524 · NPPES record last updated Dec 28, 2022
Key facts
- NPI
- 1952014524
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- CLOVIS SKILLED CARE LLC
- Practice address
- 111 Barstow Ave
Clovis, CA 93612-2225 - Phone
- (559) 299-2591
- NPI assigned
- Dec 28, 2022
- Organization subpart
- No
Authorized official
- Name
- Scott Kirby
- Title
- Manager
- Phone
- (619) 201-5888
Owners & managing parties with NPI records 1
-
Stephen Michael Grossman, M.D.
Facilities with the same owner 8
Affiliated clinicians 2
Medicare Care Compare: Nursing home
- Listed as
- Morning Star Post Acute
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 26, 1972
- Medicare certification status
- Active
- Certified beds
- 57 · 51.4 residents per day on average
- Chain
- Jericho Care Group
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 056338
- Legal name
- CLOVIS SKILLED CARE LLC
- Doing business as
- MORNING STAR POST ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 26, 1972
- Last certification
- Dec 10, 2024
- Beds
- 57
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Jericho Care Group
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 12, 2022 in CA
- Enrollment address
- 111 Barstow Ave
Clovis, CA 93612-2225 - Nursing home name
- MORNING STAR POST ACUTE
- Affiliated entity
- JERICHO CARE GROUP
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Kimberly Beatrez |
Operational/Managerial Control | May 10, 2006 | |
| Adp of the SNF | May 10, 2006 | ||
| Donald Adam Salow |
5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 24.5% |
| Indirect Ownership Interest | Dec 1, 2022 | 24.5% | |
| Sebastian Lopez |
Operational/Managerial Control | Dec 18, 2023 | |
| Adp of the SNF | Dec 18, 2023 | ||
| Benjamin T Carter |
5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 24.5% |
| Indirect Ownership Interest | Dec 1, 2022 | ||
| Scott Kirby |
5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 51% |
| Indirect Ownership Interest | Dec 1, 2022 | 51% | |
| Jason Parrott |
Operational/Managerial Control | Jan 30, 2023 | |
| Adp of the SNF | Jan 30, 2023 | ||
| Stephen M Grossman |
Operational/Managerial Control | Jul 1, 2014 | |
| Adp of the SNF | Jul 1, 2014 | ||
| Bayshire LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 51% |
| Bayshire Central Valley LLC |
5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 100% |
| Stephen N Badger |
Operational/Managerial Control | Apr 1, 2024 | |
| Adp of the SNF | Apr 1, 2024 | ||
| Donna M. Rogers |
Operational/Managerial Control | Jul 1, 2024 | |
| Adp of the SNF | Jul 1, 2024 | ||
| Micaela Hernandez Vallejo |
Operational/Managerial Control | Feb 1, 2023 | |
| Adp of the SNF | Feb 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231114002335 | CA | Part a Provider - Skilled Nursing Facility | 1658728506 | Practice locations: Clovis, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
111 Barstow Ave
Clovis, CA 93612-2225
Mailing address
1817 Avenida del Diablo
Escondido, CA 92029-3112
Other providers in Clovis, CA
- Clovis Global Academy
- Clovis Hybrid Autism Program (Chaps)
- Clovis II Bayrakdarian, D.M.D., a Professional Corporation
- Clovis Medical Group Inc
- Clovis Pediatric Group
- Clovis Urgent Care Medical Center
- Allen O Clyde
- Allen Co
- Kimberlee Lynne Cobarruvias
- Gabrielle Codianni-Reta
All providers in Clovis, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.