Organization Active NPI

Lawrenceville SNF Operations LLC

Doing business as Lawrenceville Health & Rehabilitation

  • Skilled Nursing Facility
  • Lawrenceville, VA
National Provider Identifier
1992420475
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAWRENCEVILLE SNF OPERATIONS LLC
Doing business as
Lawrenceville Health & Rehabilitation
Practice address
1722 Lawrenceville Plank Rd
Lawrenceville, VA 23868-3351
Phone
(434) 848-4766
NPI assigned
Oct 7, 2022
Last updated
Oct 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Joseph Lieberman
Title
Vice President of Procurement
Phone
(917) 836-0769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1722 Lawrenceville Plank Rd
Lawrenceville, VA 23868-3351

Mailing address

1722 Lawrenceville Plank Rd
Lawrenceville, VA 23868-3351
Phone (434) 848-4766

Other names 1

  • Lawrenceville Health & Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230104002776 VA Part A Provider - Skilled Nursing Facility 6709256902 Practice locations: Lawrenceville, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992420475. Details of each certification follow.

Skilled nursing facility certification: CCN 495192

Legal name
LAWRENCEVILLE SNF OPERATIONS LLC
Doing business as
LAWRENCEVILLE HEALTH & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 2, 1989
Last certification
Mar 19, 2025
Beds
77
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Hill Valley Health Care
Most recent change of ownership
Dec 1, 2022
Organization structure
LLCProprietary
Incorporated
Jul 22, 2022 in NE
Enrollment address
1722 Lawrenceville Plank Rd
Lawrenceville, VA 23868-3351
Nursing home name
LAWRENCEVILLE HEALTH & REHABILITATION
Affiliated entity
HILL VALLEY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lawrenceville Health & RehabilitationCCN 495192 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 2, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7773.1 residents per day on average
Chain
Hill Valley Healthcare43 facilities in the chain

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
49D1026788Lawrenceville Health & Rehabilitation1722 Lawrenceville Plank Road, Lawrenceville, VA 23868Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory

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
Sabrina 1818 Holdings LLC Organization, Flushing, NY LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 48.75%
VA 6 SNF Operations Holdings LLC Organization, Woodmere, NY LLC 5% Or Greater Direct Ownership Interest Dec 1, 2022 100%
Saessy Irrevocable Trust Organization, Cleveland, OH 5% Or Greater Indirect Ownership Interest Dec 1, 2022 46.36%
Shimon Idels Individual Corporate OfficerAuthorized Individual Dec 1, 2022
Angela Walker Individual W-2 Managing EmployeeAdministrator Dec 1, 2022
Tatiriq Irrevocable Trust Organization, Flushing, NY 5% Or Greater Indirect Ownership Interest Dec 1, 2022 46.36%
Lion 26 Holdings LLC Organization, Flushing, NY LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 48.75%

Facilities with the same owner 47

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

View all 47

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": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1992420475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 LAWRENCEVILLE PLANK RD",
            "city": "LAWRENCEVILLE",
            "state": "VA",
            "postal_code": "238683351",
            "telephone_number": "434-848-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 LAWRENCEVILLE PLANK RD",
            "city": "LAWRENCEVILLE",
            "state": "VA",
            "postal_code": "238683351",
            "telephone_number": "434-848-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCEVILLE SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PROCUREMENT",
        "authorized_official_telephone_number": "917-836-0769"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawrenceville Health & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, VA

Sources for this page

Verify at the official NPI Registry.