NPIMap

Organization Active NPI

Lifespace Communities Inc

Doing business as Oak Trace

  • Skilled Nursing Facility
  • Downers Grove, IL
National Provider Identifier
1023016730
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0017061 Issued in IL
Legal business name
LIFESPACE COMMUNITIES INC
Doing business as
Oak Trace
Practice address
250 Village Dr
Downers Grove, IL 60516
Phone
(630) 769-6200
Fax
(630) 769-6020
NPI assigned
Jul 7, 2005
Last updated
May 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Authorized official

Name
Jodi Hirsch
Title
SVP & General Counsel
Phone
(515) 288-5805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0017061 IL Primary

Addresses

Primary practice location

250 Village Dr
Downers Grove, IL 60516

Mailing address

4201 Corporate Dr
West Des Moines, IA 50266-5906
Phone (515) 288-5805

Other names 1

  • Oak Trace Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190724001390 IL Part A Provider - Skilled Nursing Facility 2365499720 Practice locations: Downers Grove, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023016730. Details of each certification follow.

Skilled nursing facility certification: CCN 145804

Legal name
LIFESPACE COMMUNITIES INC
Doing business as
OAK TRACE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Sep 1, 1994
Last certification
Jan 17, 2025
Beds
104
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Lifespace Communities Inc
Organization structure
CorporationNon-profit
Incorporated
Jan 29, 2018 in IA
Enrollment address
250 Village Dr
Downers Grove, IL 60516-3063
Nursing home name
OAK TRACE
Affiliated entity
LIFESPACE COMMUNITIES

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oak TraceCCN 145804 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Sep 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
104101.4 residents per day on average
Chain
Lifespace Communities15 facilities in the chain
Penalties (3 years)
1Fines totaling $13,780

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
14D2164970Oak Trace250 Village Dr, Downers Grove, IL 60516Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Life Care Retirement Communities Inc27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

515 Village Pl
Longwood, FL 32779
Phone (407) 682-0230

4201 Corporate Dr
West Des Moines, IA 50266

1290 Boyce Rd
Uppr St Clair, PA 15241
Phone (724) 655-4019

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Courtney Karl Individual W-2 Managing Employee Apr 4, 2022
Claus Jensen Individual Corporate Director Apr 26, 2023
Gary D Blackford Individual Corporate Director Dec 1, 2021
Nicholas Harshfield Individual Corporate OfficerChief Financial Officer Jul 1, 2020
Lifespace Communities Inc Organization, West Des Moines, IA Non-profit 5% Or Greater Direct Ownership Interest Jan 30, 2018 100%
Operational/Managerial Control Jan 30, 2018
Joyce Darkey-Hrinya Individual Corporate DirectorBoard Director Jan 29, 2018
Nikki Kay Kresse Individual Corporate OfficerChief People Officer Apr 19, 2021
David Solomon Williams Individual Corporate Director Dec 1, 2021
Patrick Spangler Individual Corporate DirectorBoard Director Jan 29, 2018
Jenifer Salamino Individual Corporate Director Apr 26, 2023
Neal Yanofsky Individual Corporate DirectorBoard Chair Jan 29, 2018
Jonathan Sokeye Individual Corporate Director Dec 1, 2021
Erin Pope Individual Corporate Officer Jul 25, 2022
Amy McDonough Individual Corporate Director Apr 26, 2023
Jesse Jantzen Individual Corporate OfficerPresident & Ceo Apr 1, 2020
Venita E Fields Individual Corporate DirectorBoard Vice-Chair Jan 29, 2018
Clyde Stretch Individual Corporate Director Apr 26, 2023
Ana Dutra Individual Corporate DirectorBoard Director Jan 29, 2018
Joseph T Gorman Individual Corporate OfficerSecretary Jul 26, 2022

Owners & managing parties with NPI records 9

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

  • Lifespace Communities Inc

    dba Beacon Hill

    • Skilled Nursing Facility
    • Lombard, IL
    • NPI 1750328522

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba The Waterford

    • Skilled Nursing Facility
    • Juno Beach, FL
    • NPI 1033157607

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Abbey Delray South

    • Skilled Nursing Facility
    • Delray Beach, FL
    • NPI 1073551412

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Claridge Court

    • Skilled Nursing Facility
    • Prairie Village, KS
    • NPI 1184679532

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Harbour's Edge

    • Skilled Nursing Facility
    • Delray Beach, FL
    • NPI 1215910872

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Village on the Green

    • Skilled Nursing Facility
    • Longwood, FL
    • NPI 1578500443

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Friendship Village of Bloomington

    • Skilled Nursing Facility
    • Bloomington, MN
    • NPI 1588606461

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Abbey Delray

    • Skilled Nursing Facility
    • Delray Beach, FL
    • NPI 1750337663

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lifespace Communities Inc

    dba Friendship Village of South Hills

    • Skilled Nursing Facility
    • Upper St Clair, PA
    • NPI 1881647899

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Abbey DelrayDelray Beach, FL, CCN 105335 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 9, 2009
Jul 8, 2009
Abbey Delray SouthDelray Beach, FL, CCN 105411 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 9, 2009
Jul 8, 2009
Friendship Village of BloomingtonBloomington, MN, CCN 245229 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 9, 2009
Jul 8, 2009
Friendship Village of South HillsUpper St Clair, PA, CCN 395688 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 9, 2009
Jul 8, 2009
Beacon HillLombard, IL, CCN 145522 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 9, 2009
Jul 8, 2009
Claridge CourtPrairie Village, KS, CCN 175343 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 8, 2009
The WaterfordJuno Beach, FL, CCN 105404 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 8, 2009
Apr 24, 2007
Harbour's EdgeDelray Beach, FL, CCN 105598 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1994
Jan 1, 1994
Village on the GreenLongwood, FL, CCN 105556 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1994
Jan 1, 1994
Querencia at Barton CreekAustin, TX, CCN 676198 Skilled nursing facility Operational/Managerial Control Jun 27, 2019
Greenfields of GenevaGeneva, IL, CCN 146166 Skilled nursing facility Operational/Managerial Control (100%) Feb 1, 2023
Windflower Health CenterAmarillo, TX, CCN 675904 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2023
Apr 7, 2025
Newcastle PlaceMequon, WI, CCN 525668 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 16, 2021
Apr 16, 2021
Meadow Lake Health CenterTyler, TX, CCN 676286 Skilled nursing facility Operational/Managerial Control (100%) Jul 19, 2022
Wesley Court Health CenterAbilene, TX, CCN 676090 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 19, 2022
Jul 19, 2022

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1023016730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 CORPORATE DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665906",
            "telephone_number": "515-288-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 VILLAGE DR",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60516",
            "telephone_number": "630-769-6200",
            "fax_number": "630-769-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPACE COMMUNITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "HIRSCH",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "SVP & GENERAL COUNSEL",
        "authorized_official_telephone_number": "515-288-5805"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0017061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Trace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oak Trace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.