Active NPI
Hooberry & Associates, Inc.
- Skilled Nursing Facility
- Newton Falls, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 3717
- Legal business name
- HOOBERRY & ASSOCIATES, INC.
- Practice address
- 2200 Milton Blvd
Newton Falls, OH 44444-8746 - Phone
- (330) 872-1990
- NPI assigned
- Sep 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kathy Kolesar, RN
- Title
- Administrator
- Phone
- (330) 872-1990
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3717 | OH | Primary |
Addresses
Primary practice location
2200 Milton Blvd
Newton Falls, OH 44444-8746
Mailing address
2200 Milton Blvd
Newton Falls, OH 44444-8746
Phone (330) 872-1990
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0640739 | Medicaid | OH | |
| 0566890001 | Other | OH | DMERC |
Other names 1
- LAURIE ANN NURSING HOME
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070806000016 | OH | Part A Provider - Skilled Nursing Facility | 2860583929 | Practice locations: Newton Falls, OH |
Skilled nursing facility certification: CCN 365855
- Legal name
- HOOBERRY & ASSOCIATES, INC.
- Doing business as
- COUNTRY CLUB REHABILITATION CAMPUS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1991
- Last certification
- Jun 18, 2025
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- Corporation
- Incorporated
- May 23, 1985 in OH
- Enrollment address
- 2200 Milton Blvd
Newton Falls, OH 44444-8746 - Nursing home name
- LAURIE ANN NURSING HOME
- Affiliated entity
- COUNTRY CLUB REHABILITATION CAMPUS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Laurie Ann Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 1, 1991
- Medicare certification status
- Active
- Certified beds
- 60
- Chain
- Country Club Rehabilitation Campus
National Provider Directory
National Provider Directory- Tax ID family
- Hooberry Associates Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Newton Falls, OH
- NPI 1790374742
Locations
2200 Milton Blvd
Newton Falls, OH 44444
Phone (330) 872-1990
Ownership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Noah Holland | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Nov 5, 2024 | ||
| Joshua Gresock | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Dec 12, 2024 | ||
| John Muirden-Holland | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Nov 21, 2024 | ||
| Patricia Holland-Gresock | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Nov 5, 2024 | ||
| Nicholas Holland | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Nov 5, 2024 | ||
| Benjamin Holland | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Nov 5, 2024 | ||
| Adp of the SNF | Nov 21, 2024 | ||
| Adam Holland-Gresock | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 9.8% |
| Adp of the SNF | Nov 5, 2024 | ||
| Adp of the SNF | Nov 21, 2024 | ||
| Janet Harris | 5% Or Greater Direct Ownership Interest | Dec 1, 2017 | 30% |
| Corporate Officer | Dec 1, 2017 | 30% | |
| Corporate Director | Dec 1, 2017 | 30% | |
| Operational/Managerial Control | Nov 5, 2024 | ||
| Adp of the SNF | Dec 12, 2024 |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Canton, OH
- NPI 1841442803
-
- Family Medicine Physician
- Warren, OH
- NPI 1285619239
Affiliated clinicians 2
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": "1157068800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1253145600000",
"number": "1255433413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 MILTON BLVD",
"city": "NEWTON FALLS",
"state": "OH",
"postal_code": "444448746",
"telephone_number": "330-872-1990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 MILTON BLVD",
"city": "NEWTON FALLS",
"state": "OH",
"postal_code": "444448746",
"telephone_number": "330-872-1990"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOOBERRY & ASSOCIATES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-01",
"last_updated": "2009-09-17",
"status": "A",
"authorized_official_last_name": "KOLESAR",
"authorized_official_first_name": "KATHY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "330-872-1990",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "3717",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0640739",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0566890001",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LAURIE ANN NURSING HOME",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newton Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.