COUNTRY MANOR LA MESA HEALTHCARE CENTER
NPI 1457345001
Skilled Nursing Facility in La Mesa, CA

Active since September 08, 2005CLIA 05D0711585 · Waiver
5/5
Overall Rating
5696 LAKE MURRAY BOULEVARD, LA MESA, CA 91942(619) 460-7871(619) 460-4810 Get Directions Write a Review

NPPES record last updated: July 21, 2014. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Country Manor La Mesa Healthcare Center NPPES

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

COUNTRY MANOR LA MESA HEALTHCARE CENTER (NPI 1457345001) is a healthcare organization registered as a skilled nursing facility in La Mesa, California and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jacob Wintner, Manager, as its authorized official.

NPPES Registry Identity

NPI1457345001
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameAG LA MESA, LLC
Location Address5696 LAKE MURRAY BOULEVARDLa Mesa, CA 91942
Mailing Address5696 Lake Murray BoulevardLa Mesa, CA 91942 · (619) 460-7871 · Fax (310) 574-1322
Fax(619) 460-4810
Organization SubpartNo
Authorized OfficialJacob WintnerManager · (323) 651-1808
Enumeration DateSeptember 8, 2005
Last NPPES UpdateJuly 21, 2014
NPI 1457345001 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 · 080000020
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.
5696 LAKE MURRAY BOULEVARD, La Mesa, CA 91942

Other Names 1

Doing Business AsCountry Manor La Mesa Healthcare Center

Other Identifiers 2

Medicare OSCAR/certification055910CA
MedicaidZZT05910JCA

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 05D0711585

Country Manor La Mesa Healthcare Center · La Mesa, CA
Active · expires Aug 31, 2026
CLIA Number05D0711585
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorWilfredo R. Abesamis, MD
Laboratory Phone(619) 460-7871
Laboratory LocationCountry Manor La Mesa Healthcare Center5696 Lake Murray Boulevard, La Mesa, CA 91942
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 Country Manor La Mesa Healthcare Center (CMS certification number 055910), from CMS Care Compare.

Country Manor La Mesa Healthcare Center

Nursing home · La Mesa, CA
5/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number055910
Certified Beds99 beds89 residents per day on average
Medicare & Medicaid Participant SinceMarch 22, 1968
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.
5/5
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.
4/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
28
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 2.3 · LPN 1.07 · RN 0.64
4.02 hrs per resident per day
Weekend Nurse Staffing
3.71 hrs per resident per day
Physical Therapist Staffing
0.08 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
40.7%
Registered Nurse Turnover
33.3%
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
1
Substantiated Complaints
3
Infection-Control Citations
0
Fines
1 totaling $10,000.00
Medicare Payment Denials
0
Total Penalties
1
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 Ag La Mesa, LLC's NPI number?

The NPI number for Ag La Mesa, LLC is 1457345001. It was assigned to this organization in the NPPES registry on September 8, 2005. The provider is doing business as Country Manor La Mesa Healthcare Center.

Where is Ag La Mesa, LLC located?

Ag La Mesa, LLC is located at 5696 Lake Murray Boulevard, La Mesa, CA 91942. The listed phone number is (619) 460-7871.

What is Ag La Mesa, LLC's specialty?

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

Does Ag La Mesa, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0711585) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Ag La Mesa, LLC a Medicare-certified nursing home?

Yes. Country Manor La Mesa Healthcare Center is a Medicare-certified nursing home with 99 certified beds.

What quality rating does Ag La Mesa, LLC have?

CMS rates Country Manor La Mesa 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 Ag La Mesa, LLC was last updated on July 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.