Alden-Long Grove Rehabilitation and Health Care Center, Inc.
Organization Active NPI Skilled Nursing Facility · Long Grove, IL
NPI 1972590230 · NPPES record last updated Jun 28, 2010
Key facts
- NPI
- 1972590230
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0040683 (IL)
- Legal business name
- ALDEN-LONG GROVE REHABILITATION AND HEALTH CARE CENTER, INC.
- Practice address
- Box 2308 Old Hicks Road
Long Grove, IL 60047-8373 - Phone
- (847) 438-8275
- Fax
- (847) 438-3254
- NPI assigned
- Oct 3, 2005
- Organization subpart
- No
Authorized official
- Name
- Floyd A Schlossberg
- Title
- President
- Phone
- (773) 286-6622
Owners & managing parties with NPI records 1
-
Kirsten Refvik, LCSW
Corporate family (same tax ID) 1
Facilities with the same owner 28
Affiliated clinicians 4
-
Behzad Farah, MD
-
Alex Kostiv, M.D.
-
Kirill Zhadovich, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Alden Long Grove Rehab &HC Ctr
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 12, 1996
- Medicare certification status
- Active
- Certified beds
- 248 · 169.5 residents per day on average
- Chain
- The Alden Network
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 4 · fines totaling $199,483
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145872
- Legal name
- ALDEN-LONG GROVE REHABILITATION AND HEALTH CARE CENTER, INC.
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Mar 12, 1996
- Last certification
- Dec 4, 2024
- Beds
- 248
- Ownership / control type
- Corporation
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 9, 1995 in IL
- Enrollment address
- Box 2308 Old Hicks Road
Long Grove, IL 60047-8373 - Nursing home name
- ALDEN LONG GROVE REHAB &HC CTR
- Affiliated entity
- THE ALDEN NETWORK
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Yvette Saldana |
W-2 Managing Employee |
Oct 22, 2018 | 100% |
| Arin G Elisco |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Garrett E Magnusson |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Joan P Carl |
Corporate Officer | May 10, 2010 | |
| Corporate Director |
May 10, 2010 | ||
| Alden Management Services, Inc. |
Operational/Managerial Control | Oct 9, 1996 | 100% |
| Esther J Davis |
Operational/Managerial Control |
Mar 15, 2010 | |
| Randi Schullo Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Feb 28, 2018 | 20.77% |
| Joseph Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Robert J Molitor |
Operational/Managerial Control |
Jun 16, 2008 | |
| Lauren Magnusson Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Feb 28, 2018 | 20.77% |
| The Alden Group, LTD. |
5% Or Greater Direct Ownership Interest | Oct 9, 1996 | 100% |
| Paige a Magnusson |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Kirsten Refvik |
W-2 Managing Employee |
Mar 13, 2017 | 100% |
| Nicole Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Margo Marasa |
Operational/Managerial Control |
Sep 12, 2011 | |
| Randi Schullo |
Corporate Officer | Feb 16, 2010 | |
| Charles L Elisco |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Midcap Funding IV Trust |
5% Or Greater Security Interest | Jul 1, 2010 | 26% |
| Floyd a Schlossberg |
Corporate Officer | May 10, 2010 | |
| Corporate Director |
May 10, 2010 | ||
| Audra Elisco Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 20.77% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110103000569 | IL | Part a Provider - Skilled Nursing Facility | 4688862816 | Practice locations: Long Grove, IL |
National Provider Directory
- Tax ID family
- Alden Long Grove Rehab HC Ctr
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0040683 | IL | Yes |
Addresses
Primary practice location
Box 2308 Old Hicks Road
Long Grove, IL 60047-8373
Mailing address
4200 W Peterson Ave
Suite 140
Chicago, IL 60646-6074
Phone (773) 286-6622
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1113 | Other | IL | BLUE CROSS |
Other providers in Long Grove, IL
- Poorvi D Ajmera
- Harout James Akmakjian
- Sam Akmakjian
- Marwah Alchalabi
- Alden Long Grove Rehabilitation and Health Care Center, Inc.
- Caitlin Anderlik
- Associated Dental Specialists of Long Grove LTD
- Nancy Awadallah
- Lisa Babin
- Richard Baker
All providers in Long Grove, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2010. 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.