Organization Active NPI

Christian Community Home of Hudson, Inc

Doing business as Christian Community Home

  • Skilled Nursing Facility
  • Hudson, WI
National Provider Identifier
1568459840
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2664 Issued in WI
Legal business name
CHRISTIAN COMMUNITY HOME OF HUDSON, INC
Doing business as
Christian Community Home
Practice address
1320 Wisconsin St
Hudson, WI 54016-1861
Phone
(715) 386-9303
NPI assigned
Oct 3, 2005
Last updated
Mar 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTIAN COMMUNITY HOMES AND SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Mrs. Pamela Klingfus
Title
Ceo
Phone
(715) 381-4210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X
Skilled Nursing Facility 314000000X 2664 WI Primary

Addresses

Primary practice location

1320 Wisconsin St
Hudson, WI 54016-1861

Mailing address

1320 Wisconsin St
Hudson, WI 54016-1861
Phone (715) 386-9303

Other identifiers 1

IdentifierTypeStateIssuer
20108600MedicaidWI

Other names 1

  • CHRISTIAN COMMUNITY HOME Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120120000143 WI Part A Provider - Skilled Nursing Facility 7719073832 Practice locations: Hudson, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568459840. Details of each certification follow.

Skilled nursing facility certification: CCN 525626

Legal name
CHRISTIAN COMMUNITY HOME OF HUDSON, INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1997
Last certification
Feb 12, 2025
Beds
50
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 25, 1980 in WI
Enrollment address
1320 Wisconsin St
Hudson, WI 54016-1861
Nursing home name
CHRISTIAN COMMUNITY HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Christian Community HomeCCN 525626 · All quality measures
Overall star rating
5 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5037.2 residents per day on average
Penalties (3 years)
1Fines totaling $5,293

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0670877Christian Community Home1320 Wisconsin St, Hudson, WI 54016Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Daryl Simonson Individual Corporate DirectorBoard Member Jun 1, 2018
Adp of the SNF May 1, 2025
James Kaczrowski Individual Corporate OfficerDirector of Finance Jan 6, 2022
Operational/Managerial Control Jan 6, 2022
Adp of the SNF Jan 6, 2022
Elliot Anderson Individual Corporate DirectorBoard Member Jun 1, 2022
Adp of the SNF Jun 1, 2022
Robert Staebell Individual Corporate DirectorBoard Member Jun 1, 2022
Adp of the SNF May 1, 2025
Pamela Klingfus Individual Corporate OfficerCeo May 17, 2021
Operational/Managerial Control May 17, 2021
Adp of the SNF May 17, 2021
Mike Bebault Individual Corporate DirectorBoard Member Jun 1, 2023
Adp of the SNF May 1, 2026
Jack Starr Individual Corporate DirectorBoard Member Jun 1, 2020
Adp of the SNF May 1, 2025
Rhonda Dunham Individual Corporate DirectorBoard Member Jun 1, 2023
Adp of the SNF May 1, 2026
Claire Zajac Individual Corporate DirectorBoard Member Sep 1, 2021
Adp of the SNF May 1, 2025
Daniel Fahs Individual Corporate DirectorBoard Member Jun 1, 2024
Adp of the SNF May 1, 2025
Thomas Field Individual Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Christian Community Homes and Services Inc Organization, Hudson, WI Corporation, Non-profit Operational/Managerial Control Jan 1, 1980
John Gerritts Individual Corporate DirectorDirector of Finance Jun 1, 2022
Adp of the SNF May 1, 2025
Craig Gibson Individual Corporate DirectorBoard Member Jun 1, 2022
Adp of the SNF May 1, 2025
Eric Johnson Individual Corporate DirectorBoard Member Sep 1, 2021
Adp of the SNF May 1, 2025
Aaron Mork Individual Corporate DirectorBoard Member Jun 1, 2023
Adp of the SNF May 1, 2025
Wintergreen Apartments, Inc. Organization, Hudson, WI Corporation, Non-profit Adp of the SNF Apr 28, 2026
Debra Schwab Individual Corporate DirectorBoard Member Jun 1, 2021
Adp of the SNF May 1, 2025
Jennie Orman Individual Operational/Managerial Control Aug 1, 2006
Adp of the SNF Aug 1, 2006

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baldwin Care CenterBaldwin, WI, CCN 525502 Skilled nursing facility Adp of the SNF Oct 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 1

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 11

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": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1568459840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161861",
            "telephone_number": "715-386-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161861",
            "telephone_number": "715-386-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COMMUNITY HOME OF HUDSON, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIAN COMMUNITY HOMES AND SERVICES, INC.",
        "enumeration_date": "2005-10-03",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "KLINGFUS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "715-381-4210",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20108600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTIAN COMMUNITY HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.