Organization Active NPI

FHS Pine Grove, Inc.

Doing business as Pine Grove Healthcare Center

  • Skilled Nursing Facility
  • Geneva, OH
National Provider Identifier
1538658489
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1405N Issued in OH
Legal business name
FHS PINE GROVE, INC.
Doing business as
Pine Grove Healthcare Center
Practice address
840 Sherman St
Geneva, OH 44041-9101
Phone
(440) 415-0502
Fax
(440) 415-0504
NPI assigned
May 7, 2018
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Sandy Muir
Title
Corporate Secretary
Phone
(440) 793-2245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1405N OH Primary

Addresses

Primary practice location

840 Sherman St
Geneva, OH 44041-9101

Mailing address

25000 Country Club Blvd Ste 255
North Olmsted, OH 44070-5337
Phone (440) 614-0160

Other names 1

  • PINE GROVE HEALTHCARE CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181210000143 OH Part A Provider - Skilled Nursing Facility 9234473810 Practice locations: Geneva, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538658489. Details of each certification follow.

Skilled nursing facility certification: CCN 366366

Legal name
FHS PINE GROVE INC
Doing business as
PINE GROVE HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2008
Last certification
Apr 12, 2024
Beds
67
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
May 3, 2018 in OH
Enrollment address
840 Sherman St
Geneva, OH 44041-9101
Nursing home name
PINE GROVE HEALTHCARE CENTER
Affiliated entity
FOUNDATIONS HEALTH SOLUTIONS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pine Grove Healthcare CenterCCN 366366 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6764.3 residents per day on average
Chain
Foundations Health Solutions64 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Karim Razmjouei Individual Adp of the SNF Jun 1, 2018
Amanda Harris Individual Operational/Managerial Control Dec 1, 2023
Adp of the SNF Dec 1, 2023
John Krystowski Individual Corporate OfficerTreasurer Jun 1, 2018
Operational/Managerial Control Jun 1, 2018
Adp of the SNF Jun 1, 2018
Brian E Colleran Individual Corporate OfficerPresident Jan 1, 2019
Corporate DirectorPresident Jan 1, 2019
Operational/Managerial Control Jan 1, 2019
Adp of the SNF Jan 1, 2019
Colleran Fam TR Dated 01-01-2018 Organization, North Olmsted, OH 5% Or Greater Indirect Ownership Interest Jun 1, 2018 100%
Foundations Health LLC Organization, North Olmsted, OH LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2018 100%
Foundations Health Solutions, LLC Organization, North Olmsted, OH LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2019
Adp of the SNF Apr 17, 2025

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 64

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

View all 64

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1538658489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD STE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705337",
            "telephone_number": "440-614-0160",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 SHERMAN ST",
            "city": "GENEVA",
            "state": "OH",
            "postal_code": "440419101",
            "telephone_number": "440-415-0502",
            "fax_number": "440-415-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FHS PINE GROVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "MUIR",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "440-793-2245"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1405N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PINE GROVE HEALTHCARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Geneva, OH

Sources for this page

Verify at the official NPI Registry.