Active NPI
KC PBG Health Center, LLC
- Skilled Nursing Facility
- Palm Beach Gardens, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- KC PBG HEALTH CENTER, LLC
- Practice address
- 3600 Masterpiece Way
Palm Beach Gardens, FL 33410-2872 - Phone
- (561) 514-5000
- NPI assigned
- Apr 23, 2013
- 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
- Andrew Scott Kohlberg
- Title
- President
- Phone
- (760) 804-5900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
3600 Masterpiece Way
Palm Beach Gardens, FL 33410-2872
Mailing address
5790 Fleet St
Suite 300
Carlsbad, CA 92008-4703
Phone (760) 804-5900
Other names 1
- La Posada
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131010000040 | FL | Part A Provider - Skilled Nursing Facility | 1850525627 | Practice locations: Palm Beach Gardens, FL |
Skilled nursing facility certification: CCN 106067
- Legal name
- KC PBG HEALTH CENTER, LLC
- Doing business as
- NURSING CENTER AT LA POSADA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Mar 25, 2005
- Last certification
- Oct 30, 2024
- Beds
- 40
- Ownership / control type
- Individual
- Most recent change of ownership
- Aug 1, 2013
- Organization structure
- LLC
- Enrollment address
- 3600 Masterpiece Way
Palm Beach Gardens, FL 33410-2872 - Nursing home name
- NURSING CENTER AT LA POSADA, THE
- Affiliated entity
- KISCO SENIOR LIVING
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Nursing Center at La Posada, The
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Individual
- Certified
- Mar 25, 2005
- Medicare certification status
- Active
- Certified beds
- 40
- Chain
- Kisco Senior Living
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 23
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 |
|---|---|---|---|
| Withumsmith Brown PC | Adp of the SNF | Jan 1, 2016 | |
| Karen Davis | 5% Or Greater Indirect Ownership Interest | Aug 1, 2013 | 2.57% |
| KC PBG Health Center, LLC | 5% Or Greater Direct Ownership Interest | Aug 1, 2013 | 100% |
| Operational/Managerial Control | Aug 1, 2013 | ||
| KC Palm Beach Gardens LLC | 5% Or Greater Indirect Ownership Interest | Sep 10, 2012 | 100% |
| Adp of the SNF | Aug 22, 2025 | ||
| Careone Pharmacy Services LLC | Adp of the SNF | Apr 1, 2018 | |
| KSL Communities LP | Indirect Ownership Interest | Aug 1, 2013 | 2.34% |
| Javier J Canasi | Operational/Managerial Control | May 9, 2014 | |
| Adp of the SNF | May 9, 2014 | ||
| Kisco Senior Living LLC | Adp of the SNF | Aug 1, 2013 | |
| Jam Kohlberg Family LLC | Indirect Ownership Interest | Aug 1, 2013 | 4% |
| Sabrina Hughes-Glodon | Operational/Managerial Control | Mar 8, 2024 | |
| Adp of the SNF | Mar 8, 2024 | ||
| Horizon Loan Holdings LLC | 5% Or Greater Indirect Ownership Interest | Aug 1, 2013 | 100% |
| Adp of the SNF | Aug 1, 2013 | ||
| Scott Kohlberg | Corporate Officer | Jan 11, 2013 | |
| Operational/Managerial Control | Aug 1, 2013 | ||
| Adp of the SNF | Aug 1, 2013 | ||
| Indirect Ownership Interest | Aug 1, 2013 | 70.46% | |
| Bradley Cadiere | Operational/Managerial Control | Oct 16, 2013 | |
| Adp of the SNF | Oct 16, 2013 | ||
| Petersham General Inc | 5% Or Greater Indirect Ownership Interest | Aug 1, 2013 | 18.04% |
| Adp of the SNF | Aug 1, 2013 | ||
| James Hands | 5% Or Greater Indirect Ownership Interest | Aug 1, 2013 | 2.57% |
| KSL Associate Group Inc | Adp of the SNF | Aug 1, 2013 | |
| Health Technologies, Inc | Adp of the SNF | Jan 28, 2020 | |
| A Quality Staffing LLC | Adp of the SNF | Aug 1, 2013 | |
| Jamelia Williams | Operational/Managerial Control | Mar 20, 2025 | |
| Adp of the SNF | Mar 20, 2025 | ||
| Bmo Bank National Association | 5% Or Greater Mortgage Interest | Jun 24, 2025 | 100% |
| Adp of the SNF | Jun 24, 2025 | ||
| John Hanna | 5% Or Greater Indirect Ownership Interest | Jan 1, 2023 | 9.5% |
| Corporate Officer | Jul 1, 2018 | ||
| Operational/Managerial Control | Jul 1, 2018 | ||
| Horizon LP Uv Lender LLC | 5% Or Greater Indirect Ownership Interest | Sep 10, 2012 | 100% |
| Med-Pass Incorporated | Adp of the SNF | Apr 1, 2019 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Palm Beach Gardens, FL
- NPI 1396774584
Adp of the SNF, Operational/Managerial Control
-
- Long Term Care Pharmacy
- Deerfield Beach, FL
- NPI 1235590118
Adp of the SNF
Practitioners & affiliated clinicians
Affiliated clinicians 12
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Physical Medicine & Rehabilitation Physician
- North Palm Beach, FL
- NPI 1528002771
Nursing home
-
- Internal Medicine Physician
- Palm Beach Gardens, FL
- NPI 1124193958
Nursing home
-
- Adult Reconstructive Orthopaedic Surgery Physician
- Palm Beach Gardens, FL
- NPI 1467490763
Nursing home
-
- Internal Medicine Physician
- Palm Beach Gardens, FL
- NPI 1396738969
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1366675200000",
"number": "1962846709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5790 FLEET ST",
"address_2": "SUITE 300",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920084703",
"telephone_number": "760-804-5900",
"fax_number": "760-804-5909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 MASTERPIECE WAY",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334102872",
"telephone_number": "561-514-5000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KC PBG HEALTH CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-23",
"last_updated": "2013-04-23",
"status": "A",
"authorized_official_last_name": "KOHLBERG",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "760-804-5900"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "La Posada",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.