Organization Active NPI

St. John of God Retirement and Care Center

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1982693073
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000022 Issued in CA
Legal business name
ST. JOHN OF GOD RETIREMENT AND CARE CENTER
Practice address
2468 S St Andrews PL
Los Angeles, CA 90018-2042
Phone
(323) 731-0641
Fax
(323) 737-1452
NPI assigned
Oct 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Authorized official

Name
Mr. Patrick Okeke
Title
Ceo
Phone
(323) 731-0641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 970000022 CA Primary

Addresses

Primary practice location

2468 S St Andrews PL
Los Angeles, CA 90018-2042

Mailing address

2468 S St Andrews PL
Los Angeles, CA 90018-2042
Phone (323) 731-0641

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05253FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050328001067 CA Part A Provider - Skilled Nursing Facility 6406802909 Practice locations: Los Angeles, CA

Skilled nursing facility certification: CCN 055253

Legal name
ST. JOHN OF GOD RETIREMENT AND CARE CENTER
Doing business as
C & S HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Oct 4, 2024
Beds
156
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1942 in CA
Enrollment address
2468 S St Andrews PL
Los Angeles, CA 90018-2042
Nursing home name
ST. JOHN OF GOD RETIREMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
St. John of God RetirementCCN 055253
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
156132.1 residents per day on average
Penalties (3 years)
4Fines totaling $124,440

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

2035 W Adams Blvd
Los Angeles, CA 90018
Phone (213) 731-0641

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Kirk M Uomoto Individual Contracted Managing EmployeeMD; Jan 1, 2024
Corporate DirectorBoard Member, Medical Director Jan 1, 2024
Operational/Managerial Control Jan 7, 2025
Adp of the SNF Jan 8, 2025
Carlos Castillo Individual Contracted Managing EmployeeAd; Nov 1, 2024
Operational/Managerial Control Dec 27, 2024
Adp of the SNF Jan 8, 2025
Brother Ignatius Individual Corporate DirectorBoard Member Jan 1, 2024
Jose J de la Rosa Individual Corporate OfficerPresident/Chief Executive Officer Jan 1, 2022 100%
Corporate DirectorChairman of the Board of Trustees Aug 18, 2018 100%
Indirect Ownership Interest Jan 1, 2024 4%
C & S Healthcare Services Organization, Los Angeles, CA Management services company Operational/Managerial Control Dec 27, 2024
Adp of the SNF Jan 8, 2025
St. John of God Retirement and Care Center Organization, Los Angeles, CA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Nov 30, 1989 100%
Operational/Managerial Control Dec 27, 2024
Adp of the SNF Jan 8, 2025
Direct Ownership Interest Nov 30, 1989 4%
Bro Michael Bassemier Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1982693073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2468 S ST ANDREWS PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900182042",
            "telephone_number": "323-731-0641",
            "fax_number": "323-737-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2468 S ST ANDREWS PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900182042",
            "telephone_number": "323-731-0641",
            "fax_number": "323-737-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN OF GOD RETIREMENT AND CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "OKEKE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-731-0641",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05253F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.