STCH de Pere Wi Opco LLC
Organization Active NPI Community Based Hospice Care Agency · Green Bay, WI
NPI 1487378956 · NPPES record last updated May 27, 2026
Key facts
- NPI
- 1487378956
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- STCH DE PERE WI OPCO LLC
- Practice address
- 420 S Washington St Ste a
Green Bay, WI 54301-4217 - Phone
- (920) 305-7900
- NPI assigned
- Sep 28, 2022
- Organization subpart
- No
Authorized official
- Name
- Stephen Phenneger
- Title
- Cfo and President
- Phone
- (612) 544-6133
Owners & managing parties with NPI records 15
-
Glenn C Caine, D.O.
-
Andrew G Mayo, M.D.
Member of 1
Facilities with the same owner 36
Practitioners 15
-
Kimberly Kay Arndt6, LPC, CSAC
-
Glenn C Caine, D.O.
-
Jeffrey T Junig, M.D.
-
Gerald A McGlone, LCSW CADC III
-
Robert Michael Minturn, PT, DPT
-
Cynthia A Moorcroft, MPT
-
Judith A Pollard, MSW LCSW
-
Stephen H Roberts, LCSW, CSAC
-
Kathleen E Ross, LCSW
-
Avis Pauline Sierra, MS, LPC, NCC
-
Nathan A Swan, DPT
-
Frederic B Will, MD
Affiliated clinicians 6
-
Jenifer I Bassett, M.D.
-
Scott Robert Schinschke, D.O.
-
Lisa R Weber, MD
-
James M Williams, MD
-
Zheng-Hao Wu, MD
Medicare Care Compare: Hospice
- Listed as
- St Croix Hospice de Pere
- Certified
- Mar 20, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2276077 | St Croix Hospice - Green Bay | Certificate of waiver | Feb 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospice certification: CCN 521616
- Legal name
- STCH DE PERE WI OPCO LLC
- Doing business as
- ST CROIX HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 20, 2023
- Last certification
- Mar 9, 2023
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 15, 2022 in DE
- Enrollment address
- 420 S Washington St
Ste a
Green Bay, WI 54301-4217
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Melissa a Andrews |
Contracted Managing Employee |
Oct 24, 2025 | |
| Operational/Managerial Control |
Oct 24, 2025 | ||
| Antares Capital LP |
5% Or Greater Security Interest | Jul 15, 2022 | 100% |
| Andrew Graham Mayo |
W-2 Managing Employee |
Jul 15, 2022 | |
| Operational/Managerial Control |
Jul 15, 2022 | ||
| Stephen C Phenneger |
Corporate Officer |
Jul 15, 2022 | |
| Corporate Director |
Jul 15, 2022 | ||
| W-2 Managing Employee |
Jul 15, 2022 | ||
| Operational/Managerial Control |
Jul 15, 2022 | ||
| TVG-STC Intermediate Corp |
5% Or Greater Indirect Ownership Interest | Jul 15, 2022 | 100% |
| STCH Acquisition Inc |
5% Or Greater Indirect Ownership Interest | Jul 15, 2022 | 100% |
| St Croix Hospice LLC |
5% Or Greater Indirect Ownership Interest | Jul 15, 2022 | 100% |
| STCH Intermediate Inc |
5% Or Greater Indirect Ownership Interest | Jul 15, 2022 | 100% |
| Karisa a Stroetz |
W-2 Managing Employee |
Nov 5, 2023 | |
| Operational/Managerial Control |
Nov 5, 2023 | ||
| Mandy L Cogswell |
W-2 Managing Employee |
Jul 15, 2022 | |
| Operational/Managerial Control |
Jul 15, 2022 | ||
| Hig STCH II LP |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 13.71% |
| Glenn C Caine |
Contracted Managing Employee |
Apr 1, 2023 | |
| Operational/Managerial Control |
Apr 1, 2023 | ||
| SCHP Holdings LP |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| SCHP Topco Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| St Croix Hospice Acquisition Corp |
5% Or Greater Indirect Ownership Interest | Jul 15, 2022 | 100% |
| STCH Parent Inc |
5% Or Greater Indirect Ownership Interest | Jul 15, 2022 | 100% |
| Heath a Bartness |
Corporate Officer |
Jul 15, 2022 | |
| Corporate Director |
Jul 15, 2022 | ||
| W-2 Managing Employee |
Jul 15, 2022 | ||
| Operational/Managerial Control |
Jul 15, 2022 | ||
| SCHP Midco Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| SCHP Intermediate Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| SCHP Purchaser Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| STCH Wi Holdco LLC |
5% Or Greater Direct Ownership Interest | Jul 15, 2022 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230220000769 | WI | Part a Provider - Hospice | 6103298294 | Practice locations: Fond Du Lac, WI; Neenah, WI; Green Bay, WI |
National Provider Directory
Locations
420 S Washington St
Ste A
Green Bay, WI 54301
Phone (920) 305-7900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
420 S Washington St Ste a
Green Bay, WI 54301-4217
Mailing address
1175 Centre Pointe Cir
Mendota Heights, MN 55120-5500
Phone (651) 328-6934
Other names
- St Croix Hospice
Other providers in Green Bay, WI
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- Peter M Stanko
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- Alexander Starr
- Jo Anne Steber
- Laura M Stebnitz
- Savannah Steckler
- Monique M Steele
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All providers in Green Bay, WI · Community Based Hospice Care Agency in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2026. 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.