Organization Active NPI

Howell Opco LLC

Doing business as Medilodge of Livingston

  • Skilled Nursing Facility
  • Howell, MI
National Provider Identifier
1053785642
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HOWELL OPCO LLC
Doing business as
Medilodge of Livingston
Practice address
3003 W Grand River Ave
Howell, MI 48843-8539
Phone
(517) 546-4210
Fax
(517) 546-7661
NPI assigned
Nov 19, 2015
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Mr. Stacey Paul Rogers
Title
Chief Financial Officer
Phone
(502) 429-8062

Specialties & licenses 1

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

Addresses

Primary practice location

3003 W Grand River Ave
Howell, MI 48843-8539

Mailing address

7400 New la Grange Rd
Suite 100
Louisville, KY 40222-4870
Phone (502) 429-8062

Other names 1

  • Medilodge of Livingston Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160310002492 MI Part A Provider - Skilled Nursing Facility 4880990282 Practice locations: Howell, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053785642. Details of each certification follow.

Skilled nursing facility certification: CCN 235330

Legal name
HOWELL OPCO LLC
Doing business as
MEDILODGE OF LIVINGSTON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1978
Last certification
Oct 15, 2024
Beds
125
Ownership / control type
Corporation
Multi-facility organization
Prestige Healthcare
Organization structure
LLCProprietary
Incorporated
Sep 16, 2013 in DE
Enrollment address
3003 W Grand River Ave
Howell, MI 48843-8539
Nursing home name
MEDILODGE OF LIVINGSTON
Affiliated entity
MEDILODGE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Medilodge of LivingstonCCN 235330 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12597.1 residents per day on average
Chain
Medilodge53 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Howell Opco LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Cody Healthcare S Corp Organization, Agoura Hills, CA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2016 47.55%
B&Y Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest Feb 1, 2016 47.55%
Prestige Administrative Services, LLC Organization, Louisville, KY LLC, Consulting firm, For-profit Operational/Managerial Control Jan 1, 2016
Craig a Flashner Individual Corporate OfficerLLC Member Feb 1, 2016
Corporate DirectorLLC Member Feb 1, 2016
Operational/Managerial ControlLLC Member / Governing Body Feb 1, 2016
Kristine Ranel Kirk Individual W-2 Managing EmployeeRegulatory Analyst Feb 1, 2016
Robert L Norcross Individual Contracted Managing EmployeeChief Executive Officer Feb 1, 2016
Craig Flashner 2007 Trust Organization, Agoura Hills, CA 5% Or Greater Indirect Ownership Interest Feb 1, 2016 47.55%
Century Opco Group LLC Organization, Louisville, KY Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2016
B&Y Healthcare S Corp Organization, Brooklyn, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2016 47.55%
Stacey Paul Rogers Individual Contracted Managing EmployeeChief Financial Officer Feb 1, 2016
Yitzchok a Perlstein Individual Corporate OfficerLLC Member Feb 1, 2016
Corporate DirectorLLC Member Feb 1, 2016
Operational/Managerial ControlLLC Member / Governing Body Feb 1, 2016
Century Healthcare Management LLC Organization, Louisville, KY LLC, Management services company, For-profit Operational/Managerial Control Feb 1, 2016

Facilities with the same owner 77

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

View all 77

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1053785642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8062",
            "fax_number": "502-429-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438539",
            "telephone_number": "517-546-4210",
            "fax_number": "517-546-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWELL OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "502-429-8062",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medilodge of Livingston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Howell, MI

Sources for this page

Verify at the official NPI Registry.