Edgwood Mi Opco LLC
Organization Active NPI Skilled Nursing Facility · Three Rivers, MI
NPI 1962379404 · NPPES record last updated Dec 10, 2025
Key facts
- NPI
- 1962379404
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- EDGWOOD MI OPCO LLC
- Practice address
- 55378 Wilbur Rd
Three Rivers, MI 49093-8815 - Phone
- (732) 330-2157
- NPI assigned
- Oct 20, 2025
- Organization subpart
- No
Authorized official
- Name
- Esti Pruzansky
- Title
- Ar
- Phone
- (732) 330-2157
Owners & managing parties with NPI records 1
-
Garrett Howard Smith, M.D.
Facilities with the same owner 5
Practitioners 2
-
Tahir Alvi, M.D.
Affiliated clinicians 2
-
Tahir Alvi, M.D.
Medicare Care Compare: Nursing home
- Listed as
- The Orchards at Three Rivers
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1978
- Medicare certification status
- Active
- Certified beds
- 87 · 75.3 residents per day on average
- Chain
- The Orchards Michigan
- Special focus status
- SFF Candidate
- Penalties (3 years)
- 2 · fines totaling $137,535
- Ownership change
- Changed ownership in the last 12 months
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0672271 | Orchards at Three Rivers, the | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Skilled nursing facility certification: CCN 235354
- Legal name
- EDGWOOD MI OPCO LLC
- Doing business as
- THE ORCHARDS AT THREE RIVERS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1978
- Last certification
- Nov 15, 2024
- Beds
- 87
- Ownership / control type
- Corporation
- Multi-facility organization
- The Orchards of Michigan
- Organization structure
- LLC · Proprietary
- Enrollment address
- 55378 Wilbur Rd
Three Rivers, MI 49093-8815 - Nursing home name
- THE ORCHARDS AT THREE RIVERS
- Affiliated entity
- THE ORCHARDS MICHIGAN
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Garrett Smith |
Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Nov 1, 2025 | ||
| Isaac Gutman |
5% Or Greater Direct Ownership Interest | Nov 1, 2025 | 40% |
| Operational/Managerial Control | Nov 1, 2025 | ||
| Managing Control - Governing Body |
Nov 1, 2025 | ||
| Adp of the SNF | Nov 1, 2025 | ||
| Melissa S Teeple |
Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Nov 1, 2025 | ||
| White Lake Healthcare LLC |
Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Nov 1, 2025 | ||
| Jacob Taub |
5% Or Greater Direct Ownership Interest | Nov 1, 2025 | 40% |
| Operational/Managerial Control | Nov 1, 2025 | ||
| Managing Control - Governing Body |
Nov 1, 2025 | ||
| Adp of the SNF | Nov 1, 2025 | ||
| Alexander Hoffman |
5% Or Greater Direct Ownership Interest | Nov 1, 2025 | 10% |
| Managing Control - Governing Body |
Nov 1, 2025 | ||
| Adp of the SNF | Nov 1, 2025 | ||
| Randy Roberts |
Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Nov 1, 2025 | ||
| Robert Kornfeld |
5% Or Greater Indirect Ownership Interest | Nov 1, 2025 | 10% |
| Operational/Managerial Control | Nov 1, 2025 | ||
| Managing Control - Governing Body |
Nov 1, 2025 | ||
| Adp of the SNF | Nov 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251124000223 | MI | Part a Provider - Skilled Nursing Facility | 2163914532 | Practice locations: Three Rivers, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
55378 Wilbur Rd
Three Rivers, MI 49093-8815
Mailing address
175 Route 70 Ste 207
Toms River, NJ 08755-0936
Phone (732) 330-2157
Other providers in Three Rivers, MI
- Sharon Gail Dolfin
- Chloe Dugan
- Brooke Taylor Eager
- Daniel Ebenhoeh
- Rachael Lynn Eberstein
- Abigail Edson
- Karalyn Eldridge
- Elite Emergency Physicians of Michigan PC
- Madison Ely
- Emdr and Wellness Solutions
All providers in Three Rivers, MI · Skilled Nursing Facility in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2025. 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.