NPIMap

Organization Active NPI

Jackson River Holdings LLC

  • Skilled Nursing Facility
  • Livermore, CA
National Provider Identifier
1962034496
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
JACKSON RIVER HOLDINGS LLC
Practice address
752 Holmes St
Livermore, CA 94550-4229
Phone
(925) 447-2280
NPI assigned
Feb 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Myrna De Guzman
Title
Corporate Controller
Phone
(760) 331-3177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

752 Holmes St
Livermore, CA 94550-4229

Mailing address

16885 W Bernardo Dr Ste 216
San Diego, CA 92127-1620
Phone (760) 331-3177

Other names 1

  • STRATFORD VILLA POST-ACUTE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505000774 CA Part A Provider - Skilled Nursing Facility 6406287598 Practice locations: Livermore, CA

Skilled nursing facility certification: CCN 555899

Legal name
JACKSON RIVER HOLDINGS LLC
Doing business as
STRATFORD VILLA POST-ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 16, 2016
Last certification
Mar 21, 2024
Beds
27
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Links Healthcare Group, LLC
Organization structure
LLCProprietary
Incorporated
Dec 18, 2019 in CA
Enrollment address
752 Holmes St
Livermore, CA 94550-4229
Nursing home name
STRATFORD VILLA POST-ACUTE
Affiliated entity
LINKS HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Stratford Villa Post-AcuteCCN 555899
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 16, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2723.9 residents per day on average
Chain
Links Healthcare Group32 facilities in the chain
Penalties (3 years)
3Fines totaling $46,779

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
05D2207080Stratford Villa Post-Acute752 Holmes Street, Livermore, CA 94550Certificate of waiverDec 22, 2026

National Provider Directory

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
Mary Beardsley Individual Adp of the SNF Mar 1, 2020
Toby Tilford Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2020 46.6%
Corporate OfficerManager Mar 1, 2020
Operational/Managerial Control Mar 1, 2020
Adp of the SNF Mar 1, 2020
Chad Anderson Individual Adp of the SNF Mar 1, 2020
Isabel Poderoso Individual Adp of the SNF Mar 1, 2020
Scott Clawson Individual General Partnership Interest Mar 1, 2020 4%
Antonette D Frojelin Individual Adp of the SNF Mar 1, 2020
Steven Earl Individual General Partnership Interest Mar 1, 2020 0.8%
Links Support Services, LLC Organization, San Diego, CA LLC Operational/Managerial Control Mar 1, 2020
Adp of the SNF Jul 16, 2025
Myrna a Deguzman Individual Adp of the SNF Mar 1, 2020
Victoria Bernholz Individual Adp of the SNF Mar 1, 2020
Narendra Malani Individual Adp of the SNF Mar 1, 2020
Melissa Carter Individual Adp of the SNF Mar 1, 2020
Forbright Bank Organization, Chevy Chase, MD Financial institution 5% Or Greater Security Interest Mar 1, 2020 100%
Links Healthcare Group LLC Organization, San Diego, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2020 100%
Operational/Managerial Control Mar 1, 2020
Adp of the SNF Jul 16, 2025
Coleta Morales Individual Adp of the SNF Mar 1, 2020
Eide Bailly LLP Organization, Salt Lake City, UT Adp of the SNF Mar 1, 2020
Ellen R Subia Individual Adp of the SNF Mar 1, 2020
Jack Sanofsky Individual General Partnership Interest Mar 1, 2020 2%
Ciress LLC Organization, Orinda, CA LLC, Owned by another organization or individual 5% Or Greater Security Interest Mar 1, 2020 100%
Adp of the SNF Mar 1, 2020
Sharon Ramirez Individual Adp of the SNF Mar 1, 2020
Curtis Rodriguez Individual 5% Or Greater Indirect Ownership InterestManager Mar 1, 2020 46.6%
Corporate OfficerManager Mar 1, 2020
Operational/Managerial Control Mar 1, 2020
Adp of the SNF Mar 1, 2020

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 30

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

View all 30

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": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1962034496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16885 W BERNARDO DR STE 216",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271620",
            "telephone_number": "760-331-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 HOLMES ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504229",
            "telephone_number": "925-447-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON RIVER HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_title_or_position": "CORPORATE CONTROLLER",
        "authorized_official_telephone_number": "760-331-3177"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STRATFORD VILLA POST-ACUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livermore, CA

Sources for this page

Verify at the official NPI Registry.