Willow Haven Opco, LLC
Organization Active NPI Skilled Nursing Facility · Zanesville, OH
NPI 1194292292 · NPPES record last updated Oct 23, 2024
Key facts
- NPI
- 1194292292
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- WILLOW HAVEN OPCO, LLC
- Practice address
- 1020 Taylor St
Zanesville, OH 43701-2656 - Phone
- (740) 454-9747
- Fax
- (740) 455-7856
- NPI assigned
- Oct 26, 2018
- Organization subpart
- No
Authorized official
- Name
- Jason Dipasqua
- Title
- Coo
- Phone
- (330) 652-2053
Facilities with the same owner 6
Practitioners 2
-
Paul D Mumma, D.O.
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Continuing Healthcare at Willow Haven
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 27, 2002
- Medicare certification status
- Active
- Certified beds
- 81 · 72.2 residents per day on average
- Chain
- Certus Healthcare
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0856516 | Continuing Healthcare Willow Haven | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 366244
- Legal name
- CONTINUING HEALTHCARE WILLOW HAVEN LLC
- Doing business as
- CONTINUING HEALTHCARE WILLOW HAVEN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 27, 2002
- Last certification
- Mar 28, 2024
- Beds
- 81
- Ownership / control type
- Corporation
- Multi-facility organization
- Certus Healthcare
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 13, 2018 in OH
- Enrollment address
- 1020 Taylor St
Zanesville, OH 43701-2656 - Nursing home name
- CONTINUING HEALTHCARE AT WILLOW HAVEN
- Affiliated entity
- CERTUS HEALTHCARE
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Shmuel Fishman |
5% Or Greater Indirect Ownership Interest |
Dec 28, 2021 | 27.5% |
| Corporate Officer |
Dec 28, 2021 | 50% | |
| Joseph Orgel |
5% Or Greater Indirect Ownership Interest | Dec 28, 2021 | 25% |
| Jason Dipasqua |
5% Or Greater Indirect Ownership Interest |
Dec 28, 2021 | 22.5% |
| Corporate Officer |
Dec 28, 2021 | 50% | |
| W-2 Managing Employee |
Dec 28, 2021 | 100% | |
| Joel Zupnick |
5% Or Greater Indirect Ownership Interest | Dec 28, 2021 | 16% |
| CHM Oh West Opco Holdco LLC |
5% Or Greater Direct Ownership Interest | Dec 28, 2021 | 100% |
| Joel Leifer |
5% Or Greater Indirect Ownership Interest | Dec 28, 2021 | 8% |
| Ohio Care SKLD LLC |
5% Or Greater Indirect Ownership Interest | Dec 28, 2021 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190306000264 | OH | Part a Provider - Skilled Nursing Facility | 9032458203 | Practice locations: Zanesville, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1020 Taylor St
Zanesville, OH 43701-2656
Mailing address
5990 Venture Dr Ste a
Dublin, OH 43017-2273
Phone (216) 772-3192
Other names
- Continuing Healthcare Willow Haven, LLC
Other providers in Zanesville, OH
- Scott Eric Williams
- Sheena M Williams
- Susan Marie Williams
- Ashlei A Willis
- Eric Willis
- Alexis Marie Wilson
- Courtney Wilson
- Laura M Wilson
- Pamela Brianne Wilson
- Vicki Lee Wilson
All providers in Zanesville, OH · Skilled Nursing Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.