Organization Active NPI

Vancrest of Troy LLC

  • Skilled Nursing Facility
  • Troy, OH
National Provider Identifier
1205645348
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
VANCREST OF TROY LLC
Practice address
3232 N County Road 25a
Troy, OH 45373-1338
Phone
(937) 440-7663
NPI assigned
Jan 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Authorized official

Name
Edgar Silalahi
Title
Cfo
Phone
(419) 238-0715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3232 N County Road 25a
Troy, OH 45373-1338

Mailing address

120 W Main St Ste 200
Van Wert, OH 45891-1761
Phone (419) 238-0715

Other identifiers 1

IdentifierTypeStateIssuer
0092736MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250505001233 OH Part A Provider - Skilled Nursing Facility 4385161363 Practice locations: Troy, OH

Skilled nursing facility certification: CCN 365735

Legal name
VANCREST OF TROY, LLC
Doing business as
VANCREST - UPPER VALLEY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 8, 1989
Last certification
Jul 25, 2024
Beds
127
Ownership / control type
Nonprofit Corporation
Organization structure
LLCProprietary
Enrollment address
3232 N County Road 25a
Troy, OH 45373-1338
Nursing home name
VANCREST-UPPER VALLEY
Affiliated entity
VANCREST HEALTH CARE CENTERS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vancrest-Upper ValleyCCN 365735
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 8, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
127114.5 residents per day on average
Chain
Vancrest Health Care Centers13 facilities in the chain

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
36D0715741Vancrest - Upper Valley3232 N County Road 25a, Troy, OH 45373Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 46

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

NameRoleSinceShare
Individual Adp of the SNF Dec 30, 2024
Vancrest Management Corp. Organization, Van Wert, OH Corporation, Management services company Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Scott White Individual 5% Or Greater Direct Ownership Interest Dec 30, 2024 5%
Organization, Columbus, OH Corporation Adp of the SNF Jun 12, 2025
Mark Rudasill Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Organization, Dayton, OH Corporation Adp of the SNF Dec 30, 2024
Jon D Bagley Individual 5% Or Greater Direct Ownership InterestSecretary Dec 30, 2024 15%
Corporate OfficerSecretary Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Nicolaus White Individual 5% Or Greater Direct Ownership Interest Dec 30, 2024 10%
Robert Contento Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Mark Stuart McCleery Individual 5% Or Greater Direct Ownership Interest Dec 30, 2024 40%
Individual Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Aquila Initiative Inc Organization, Massillon, OH Corporation Adp of the SNF Dec 30, 2024
Bashore Reineck Stoller & Waterman Inc Organization, Van Wert, OH Corporation Adp of the SNF Dec 30, 2024
Twomagnets LLC Organization, Pasadena, CA LLC, Medical staffing company Adp of the SNF Dec 30, 2024
Naga Prasuna Madireddy Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Claire White Individual 5% Or Greater Direct Ownership Interest10 Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Kathy Parker Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Veracity Resourcing and Services LLC Organization, Dayton, OH LLC, Medical staffing company Adp of the SNF Dec 30, 2024
Organization, Van Wert, OH LLC Adp of the SNF Jun 12, 2025
Betty Allen Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Cierra Sutherland Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Mark a White Individual 5% Or Greater Direct Ownership InterestPresident Dec 30, 2024 45%
Corporate OfficerPresident Dec 30, 2024
Operational/Managerial Control Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Troy Health Facilities, LLC Organization, Van Wert, OH LLC, Management services company Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Therapy Solutions Organization, Van Wert, OH LLC, Medical provider/supplier Adp of the SNF Apr 1, 2025
Shane Stewart Individual Operational/Managerial Control Dec 30, 2024
Managing Control - Governing BodyCoo Dec 30, 2024
Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Edgar Silalahi Individual Operational/Managerial Control Dec 30, 2024
Managing Control - Governing BodyCfo Dec 30, 2024
Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024
Mark L Myers Individual 5% Or Greater Direct Ownership Interest Dec 30, 2024 10%
Elizabeth Fuelling Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Uvmc Nursing Care, Inc Organization, Troy, OH Corporation Adp of the SNF Dec 27, 1989
Individual Adp of the SNF Dec 30, 2024
Julia Pottenger Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Howard, Wershbale & Co Organization, Woodmere, OH Corporation Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Dec 30, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1735862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1205645348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 200",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911761",
            "telephone_number": "419-238-0715",
            "fax_number": "419-238-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3232 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731338",
            "telephone_number": "937-440-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCREST OF TROY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-03",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "SILALAHI",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-238-0715"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092736",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

Verify at the official NPI Registry.