Pennsylvania in-Home Partner-II, LLC
Organization Active NPI Community Based Hospice Care Agency · Johnstown, PA
NPI 1396281663 · NPPES record last updated May 21, 2020
Key facts
- NPI
- 1396281663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- PENNSYLVANIA IN-HOME PARTNER-II, LLC
- Practice address
- 210 Industrial Park Rd Ste 150
Johnstown, PA 15904-1948 - Phone
- (814) 534-6100
- Fax
- (814) 534-6105
- NPI assigned
- Jan 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Nicholas Gachassin III
- Title
- Secretary
- Phone
- (337) 233-1307
Corporate family (same tax ID) 1
Change of ownership 1
Facilities with the same owner 198
Affiliated clinicians 1
Medicare Care Compare: Hospice
- Listed as
- Conemaugh Regional Hospice
- Ownership
- For-Profit
- Certified
- Jan 5, 1993
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2125802 | Pennsylvania in-Home Partner-II, LLC | Certificate of waiver | Feb 13, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Hospice certification: CCN 391565
- Legal name
- PENNSYLVANIA IN-HOME PARTNER-II LLC
- Doing business as
- CONEMAUGH REGIONAL HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jan 5, 1993
- Last certification
- Dec 23, 2020
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 18, 2016 in PA
- Enrollment address
- 210 Industrial Park Rd
Ste 150
Johnstown, PA 15904-1948
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 80% |
| Erica Facciani |
W-2 Managing Employee |
Sep 24, 2024 | |
| Home Health Partner LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 20% |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Apr 13, 2026 | |
| W-2 Managing Employee |
Apr 13, 2026 | ||
| LHCG Partner LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 80% |
| Joni Babineaux |
Corporate Officer |
Apr 13, 2026 | |
| Lifepoint Hospitals Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 80% |
| Historic Lifepoint Hospitals, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 20% |
| In-Home Healthcare Partnership LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2017 | 100% |
| Pennsylvania in-Home Healthcare Partnership-II LLC |
5% Or Greater Direct Ownership Interest | Jan 1, 2017 | 100% |
| Wendy S Daigle |
Corporate Director |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 80% |
| Operational/Managerial Control | Jan 1, 2017 | ||
| Joshua Lee Proffitt |
Corporate Officer |
Jan 1, 2017 | |
| Legacy Lifepoint Health LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 20% |
| Amy Cormier |
Corporate Director |
May 1, 2025 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jan 1, 2017 | Change of Ownership |
Conemaugh Regional Hospice |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170321000194 | PA | Part a Provider - Hospice | 9032494745 | Practice locations: Johnstown, PA |
National Provider Directory
- Tax ID family
- Conemaugh Regional Hospice
Locations
315 Locust St
Ste 5E
Johnstown, PA 15901
Phone (814) 534-6100
210 Industrial Park Rd
Ste 150
Johnstown, PA 15904
Phone (814) 534-6100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
210 Industrial Park Rd Ste 150
Johnstown, PA 15904-1948
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103326458 | Medicaid | PA |
Other names
- Conemaugh Regional Hospice
NPI Registry JSON
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1590019200000",
"number": "1396281663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 51266",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705051266",
"telephone_number": "337-233-1307",
"fax_number": "337-233-5764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 INDUSTRIAL PARK RD STE 150",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159041948",
"telephone_number": "814-534-6100",
"fax_number": "814-534-6105"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENNSYLVANIA IN-HOME PARTNER-II, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-01-11",
"last_updated": "2020-05-21",
"certification_date": "2020-05-21",
"status": "A",
"authorized_official_last_name": "GACHASSIN",
"authorized_official_first_name": "NICHOLAS",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "337-233-1307",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103326458",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Conemaugh Regional Hospice",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Conemaugh Regional Hospice",
"code": "3",
"type": "Doing Business As"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2020. 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.