NPIMap

Organization Active NPI

Jacksonville Care and Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Jacksonville, IL
National Provider Identifier
1952955189
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
JACKSONVILLE CARE AND REHABILITATION CENTER LLC
Practice address
1517 W Walnut St
Jacksonville, IL 62650-1133
Phone
(217) 243-6451
NPI assigned
Jul 25, 2019
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Shalom Lichtman
Title
Medicare Authorized Official
Phone
(217) 243-6451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1517 W Walnut St
Jacksonville, IL 62650-1133

Mailing address

229 Route 70 Ste 100
Toms River, NJ 08755-1026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191106000803 IL Part A Provider - Skilled Nursing Facility 4688906944 Practice locations: Jacksonville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952955189. Details of each certification follow.

Skilled nursing facility certification: CCN 145273

Legal name
JACKSONVILLE CARE AND REHABILITATION CENTER LLC
Doing business as
JACKSONVILLE SKILLED NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Sep 4, 1974
Last certification
May 22, 2024
Beds
88
Ownership / control type
Individual
Organization structure
LLCProprietary
Enrollment address
1517 W Walnut St
Jacksonville, IL 62650-1133
Nursing home name
JACKSONVILLE SKLD NUR & REHAB
Affiliated entity
CREST HEALTHCARE CONSULTING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jacksonville SKLD Nur & RehabCCN 145273 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Sep 4, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8880.9 residents per day on average
Chain
Crest Healthcare Consulting11 facilities in the chain
Penalties (3 years)
2Fines totaling $23,027

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
14D0435455Jacksonville Skilled Nursing and Rehab1517 W Walnut, Jacksonville, IL 62650Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Jacksonville Care and Rehabilitation Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 1.1%
Individual Indirect Ownership Interest Mar 14, 2025 1%
Sawyer Zaerr Individual Operational/Managerial Control Apr 29, 2019
Adp of the SNF Apr 29, 2019
Crest CRJS Holdco LLC Organization, Toms River, NJ LLC, Holding company Direct Ownership Interest Mar 14, 2025 100%
Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 7.55%
Shalom Lichtman Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2019 19.94%
Corporate OfficerManager Sep 1, 2019
Operational/Managerial Control Sep 1, 2019
Managing Control - Governing BodyManager of Manager Sep 1, 2019
Adp of the SNF Sep 1, 2019
Indirect Ownership Interest Mar 14, 2025 19.94%
Ecfjc Trust Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 20.81%
Light Man LLC Organization, Chicago, IL LLC, Holding company Operational/Managerial Control Mar 14, 2025
Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 1.1%
Individual Indirect Ownership Interest Mar 14, 2025 2.16%
Individual Indirect Ownership Interest Mar 14, 2025 1.62%
Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 1.1%
Il M Trust Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 7.55%
Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 20.81%
Tsdama Trust Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 20.81%
Mrs Windy City State Trust Organization, Toms River, NJ Indirect Ownership Interest Mar 14, 2025 20.81%
Bhavin Vallabhbhai Sonani Individual Operational/Managerial Control May 13, 2023
Adp of the SNF May 13, 2023
Individual Indirect Ownership Interest Mar 14, 2025 1%
Individual Indirect Ownership Interest Mar 4, 2025 1%
Capital Finance LLC Organization, Baltimore, MD Financial institution 5% Or Greater Security Interest Sep 1, 2019
Crest CRJS TBD Holdco LLC Organization, Toms River, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Mar 14, 2025 100%

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 17

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

View all 17

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1952955189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 ROUTE 70 STE 100",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501133",
            "telephone_number": "217-243-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE CARE AND REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "LICHTMAN",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "MEDICARE AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "217-243-6451"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.