Active NPI
Daytona Beach FL Opco LLC
- Skilled Nursing Facility
- Daytona Beach, FL
National Provider Identifier
1952936742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- DAYTONA BEACH FL OPCO LLC
- Practice address
- 1001 S Beach St
Daytona Beach, FL 32114-6204 - Phone
- (386) 258-3334
- NPI assigned
- Mar 11, 2020
- 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
- Batya Gorelick
- Title
- VP of Administrative Services
- Phone
- (386) 258-3334
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary | ||
| Respite Care | 385H00000X |
Addresses
Primary practice location
1001 S Beach St
Daytona Beach, FL 32114-6204
Mailing address
440 Sylvan Ave Ste 240
Englewood Cliffs, NJ 07632-2700
Phone (773) 633-6795
Other names 2
- Beach Street Health and Rehabilitation Center
- Orchid Cove at Daytona
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210816003952 | FL | Part A Provider - Skilled Nursing Facility | 1658776513 | Practice locations: Daytona Beach, FL |
Skilled nursing facility certification: CCN 105002
- Legal name
- DAYTONA BEACH FL OPCO LLC
- Doing business as
- BEACH STREET HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Sep 25, 2024
- Beds
- 99
- Ownership / control type
- Corporation
- Multi-facility organization
- Lilac Health Group
- Most recent change of ownership
- Apr 1, 2017
- Organization structure
- LLC
- Incorporated
- Mar 16, 2020 in FL
- Enrollment address
- 1001 S Beach St
Daytona Beach, FL 32114-6204 - Nursing home name
- BEACH STREET HEALTH AND REHABILITATION CENTER
- Affiliated entity
- SIMCHA HYMAN & NAFTALI ZANZIPER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Beach Street Health and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 99
- Chain
- Simcha Hyman & Naftali Zanziper
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Ownership & related parties
All disclosed owners & managing parties 4
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 |
|---|---|---|---|
| Keith Demons | W-2 Managing Employee | Mar 16, 2020 | |
| Batya Gorelick | Corporate Officer | Mar 16, 2020 | |
| Simcha Melech Hyman | 5% Or Greater Direct Ownership Interest | Mar 16, 2020 | 50% |
| Naftali Zanziper | 5% Or Greater Direct Ownership Interest | Mar 16, 2020 | 50% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1669161600000",
"number": "1952936742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 SYLVAN AVE STE 240",
"city": "ENGLEWOOD CLIFFS",
"state": "NJ",
"postal_code": "076322700",
"telephone_number": "773-633-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 S BEACH ST",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321146204",
"telephone_number": "386-258-3334"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAYTONA BEACH FL OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-11",
"last_updated": "2022-11-23",
"certification_date": "2022-11-23",
"status": "A",
"authorized_official_last_name": "GORELICK",
"authorized_official_first_name": "BATYA",
"authorized_official_title_or_position": "VP OF ADMINISTRATIVE SERVICES",
"authorized_official_telephone_number": "386-258-3334"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Beach Street Health and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Orchid Cove at Daytona",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.