825 Summit Street Operations LLC
Organization Active NPI Skilled Nursing Facility · Spencer, WV
NPI 1265616445 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1265616445
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 132 (WV)
- Legal business name
- 825 SUMMIT STREET OPERATIONS LLC
- Practice address
- 825 Summit St
Spencer, WV 25276-1035 - Phone
- (304) 927-1007
- Fax
- (304) 927-5830
- NPI assigned
- Dec 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael T Berg
- Title
- Secretary
- Phone
- (610) 444-6350
Owners & managing parties with NPI records 1
-
Carroll D Christiansen, M.D.
Facilities with the same owner 178
Practitioners 1
-
Carroll D Christiansen, M.D.
Affiliated clinicians 2
-
Carroll D Christiansen, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Miletree Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Dec 1, 2002
- Medicare certification status
- Active
- Certified beds
- 62 · 59.5 residents per day on average
- Chain
- Genesis Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Skilled nursing facility certification: CCN 515182
- Legal name
- 825 SUMMIT STREET OPERATIONS LLC
- Doing business as
- MILETREE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 2002
- Last certification
- Jul 11, 2024
- Beds
- 62
- Ownership / control type
- Corporation
- Multi-facility organization
- Genesis
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 16, 2007 in WV
- Enrollment address
- 825 Summit St
Spencer, WV 25276-1035 - Nursing home name
- MILETREE CENTER
- Affiliated entity
- GENESIS HEALTHCARE
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| Laura Bridgeford |
Corporate Officer |
Jun 1, 2024 | |
| HCCF Management Group XI LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 14.73% |
| Christiana Starcher |
Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Feb 9, 2025 | ||
| Gen Operations I LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Gen Operations II LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Genesis WV Holdings LLC |
5% Or Greater Direct Ownership Interest | Apr 1, 2011 | 100% |
| FC-Gen Operations Investment LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Genesis Operations LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Carroll D Christiansen |
Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Feb 9, 2025 | ||
| Sundance Rehabilitation Holdco Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 5.81% |
| Genesis Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Sun Healthcare Group Inc |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 52.24% |
| Welltower Op, LLC |
5% Or Greater Indirect Ownership Interest | Mar 1, 2024 | 5.7% |
| Arnold M Whitman |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 17.42% |
| Genesis Healthcare Inc |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 52.24% |
| |
Adp of the SNF | Feb 9, 2025 | |
| Zac Properties XI LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 8.48% |
| Steven E Fishman |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 11.15% |
| Avi Pinchas Mendelson |
Corporate Officer |
Jun 1, 2024 | |
| Michael T Berg |
Corporate Officer |
Mar 2, 2015 | |
| |
Adp of the SNF | Feb 9, 2025 | |
| GHC Holdings LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Genesis Holdings LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080411000370 | WV | Part a Provider - Skilled Nursing Facility | 5395822530 | Practice locations: Spencer, WV |
National Provider Directory
Locations
825 Summit St
Spencer, WV 25276
Phone (304) 923-4175
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 132 | WV | Yes |
Addresses
Primary practice location
825 Summit St
Spencer, WV 25276-1035
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002886001 | Medicaid | WV |
Other names
- Miletree Center
Other providers in Spencer, WV
All providers in Spencer, WV · Skilled Nursing Facility in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2025. 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.