CLOVERDALE HEALTHCARE CENTER
NPI 1245225176
Skilled Nursing Facility in Cloverdale, CA

Active since September 16, 2005CLIA 05D0611944 · Waiver
5/5
Overall Rating
300 CHERRY CREEK ROAD, CLOVERDALE, CA 95425(707) 894-5201(707) 894-9324 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Cloverdale Healthcare Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLOVERDALE HEALTHCARE CENTER (NPI 1245225176) is a healthcare organization registered as a skilled nursing facility in Cloverdale, California and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Soon Burnam, Authorized Agent, as its authorized official.

NPPES Registry Identity

NPI1245225176
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameENSIGN CLOVERDALE LLC
Location Address300 CHERRY CREEK ROADCloverdale, CA 95425-3811
Mailing Address300 Cherry Creek RoadCloverdale, CA 95425-3811 · (707) 894-5201 · Fax (707) 894-9324
Fax(707) 894-9324
Organization SubpartNo
Authorized OfficialSoon BurnamAuthorized Agent · (949) 540-1249
Enumeration DateSeptember 16, 2005
Last NPPES UpdateFebruary 17, 2021
NPPES CertifiedFebruary 17, 2021
NPI 1245225176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 010000157
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

300 CHERRY CREEK ROAD, Cloverdale, CA 95425

Other Names 1

Doing Business AsCloverdale Healthcare Center

Other Identifiers 1

MedicaidZZR05756ICA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0611944

Cloverdale Healthcare Center · Cloverdale, CA
Active · expires Jun 28, 2027
CLIA Number05D0611944
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJune 29, 2025
Certificate Expiration DateJune 28, 2027
Laboratory DirectorDr. Noel Serrano
Laboratory Phone(707) 894-5201
Laboratory LocationCloverdale Healthcare Center300 Cherry Creek Rd, Cloverdale, CA 95425
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Cloverdale Healthcare Center (CMS certification number 055756), from CMS Care Compare.

Cloverdale Healthcare Center

Nursing home · Cloverdale, CA
5/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number055756
Certified Beds72 beds45 residents per day on average
Medicare & Medicaid Participant SinceJuly 16, 1974
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
5/5
Long-Stay Quality
Quality of care delivered to long-term residents.
4/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
5/5
Staffing
Based on nursing staff hours relative to resident needs.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
26.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.7 · LPN 1.31 · RN 0.32
4.33 hrs per resident per day
Weekend Nurse Staffing
3.9 hrs per resident per day
Physical Therapist Staffing
0.11 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
46.6%
Registered Nurse Turnover
20%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ensign Cloverdale LLC's NPI number?

The NPI number for Ensign Cloverdale LLC is 1245225176. It was assigned to this organization in the NPPES registry on September 16, 2005. The provider is doing business as Cloverdale Healthcare Center.

Where is Ensign Cloverdale LLC located?

Ensign Cloverdale LLC is located at 300 Cherry Creek Road, Cloverdale, CA 95425. The listed phone number is (707) 894-5201.

What is Ensign Cloverdale LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Ensign Cloverdale LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0611944) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Ensign Cloverdale LLC a Medicare-certified nursing home?

Yes. Cloverdale Healthcare Center is a Medicare-certified nursing home with 72 certified beds.

What quality rating does Ensign Cloverdale LLC have?

CMS rates Cloverdale Healthcare Center 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Ensign Cloverdale LLC was last updated on February 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.