NPIMap

Organization Active NPI

Christian Park HCC Acquisition Company, LLC

  • Skilled Nursing Facility
  • Escanaba, MI
National Provider Identifier
1396742391
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHRISTIAN PARK HCC ACQUISITION COMPANY, LLC
Practice address
2415 5TH Ave S
Escanaba, MI 49829-1201
Phone
(906) 786-6907
Fax
(906) 786-8300
NPI assigned
Jul 5, 2005
Organization subpart
Yes
Parent organization
CIENA HEALTHCARE MANAGEMENT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Authorized official

Name
Mr. Mohammad Ashraf Qazi
Title
Ceo
Phone
(248) 386-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2415 5TH Ave S
Escanaba, MI 49829-1201

Mailing address

2415 5TH Ave S
Escanaba, MI 49829-1201
Phone (906) 786-6907

Other identifiers 2

IdentifierTypeStateIssuer
09995OtherBCBSM
4709183MedicaidMI

Other names 1

  • Christian Park Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000051 MI Part A Provider - Skilled Nursing Facility 5890772701 Practice locations: Escanaba, MI

Skilled nursing facility certification: CCN 235244

Legal name
CHRISTIAN PARK HCC ACQUISITION COMPANY, LLC
Doing business as
CHRISTIAN PARK HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1975
Last certification
Jan 23, 2025
Beds
99
Ownership / control type
Corporation
Multi-facility organization
Ciena Health Care Center
Organization structure
LLCProprietary
Incorporated
Apr 5, 2004 in MI
Enrollment address
2415 5TH Ave S
Escanaba, MI 49829-1201
Nursing home name
CHRISTIAN PARK HEALTH CARE CENTER
Affiliated entity
CIENA HEALTHCARE/LAUREL HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Christian Park Health Care CenterCCN 235244
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 1, 1975
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9979.5 residents per day on average
Chain
Ciena Healthcare/Laurel Health Care81 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $36,651

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

2415 5th Ave S
Escanaba, MI 49829
Phone (906) 786-6907

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Ciena Healthcare Management Inc Organization, Southfield, MI Corporation, LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Aug 2, 2004 100%
Adp of the SNF Mar 20, 2025
Individual Adp of the SNF Mar 1, 2022
Anis Khan Individual Operational/Managerial Control Aug 2, 2004
Managing Control - Governing BodyManager Aug 2, 2004
Adp of the SNF Aug 2, 2004
Colin David Irish Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Mohammad a. Qazi Individual 5% Or Greater Indirect Ownership InterestManager Aug 2, 2004 100%
Operational/Managerial Control Aug 2, 2004
Managing Control - Governing BodyManager Aug 2, 2004
Adp of the SNF Aug 2, 2004
Maryann Bond Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Mohammad a Qazi Living Trust Dated 09/26/97 Organization, West Bloomfield, MI For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 2, 2004 100%
Adp of the SNF Aug 2, 2004
Individual Adp of the SNF Dec 1, 2024
Organization, Taylor, MI LLC, For-profit Adp of the SNF Mar 20, 2025
Individual Adp of the SNF Jan 17, 2022
Individual Adp of the SNF Aug 2, 2004
Organization, Glenview, IL LLC, For-profit Adp of the SNF Mar 20, 2025
Christian Park Land Company LLC Organization, Southfield, MI LLC, For-profit Adp of the SNF Aug 2, 2004

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 76

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

View all 76

Practitioners & affiliated clinicians

Practitioners 5

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": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1396742391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 5TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291201",
            "telephone_number": "906-786-6907",
            "fax_number": "906-786-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 5TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291201",
            "telephone_number": "906-786-6907",
            "fax_number": "906-786-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN PARK HCC ACQUISITION COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CIENA HEALTHCARE MANAGEMENT, INC",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "QAZI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "ASHRAF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-386-0300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "09995",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4709183",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Park Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.