Active NPI
Christian Community Home of Hudson, Inc
Doing business as Christian Community Home
- Skilled Nursing Facility
- Hudson, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2664
- 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, 2023
- Organization subpart
- Yes
- Parent organization
- CHRISTIAN COMMUNITY HOMES AND SERVICES, INC.
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20108600 | Medicaid | WI |
Other names 1
- CHRISTIAN COMMUNITY HOME
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 1, 1997
- Medicare certification status
- Active
- Certified beds
- 50
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0670877 | Christian Community Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Daryl Simonson | Corporate Director | Jun 1, 2018 | |
| Adp of the SNF | May 1, 2025 | ||
| James Kaczrowski | Corporate Officer | Jan 6, 2022 | |
| Operational/Managerial Control | Jan 6, 2022 | ||
| Adp of the SNF | Jan 6, 2022 | ||
| Elliot Anderson | Corporate Director | Jun 1, 2022 | |
| Adp of the SNF | Jun 1, 2022 | ||
| Robert Staebell | Corporate Director | Jun 1, 2022 | |
| Adp of the SNF | May 1, 2025 | ||
| Pamela Klingfus | Corporate Officer | May 17, 2021 | |
| Operational/Managerial Control | May 17, 2021 | ||
| Adp of the SNF | May 17, 2021 | ||
| Mike Bebault | Corporate Director | Jun 1, 2023 | |
| Adp of the SNF | May 1, 2026 | ||
| Jack Starr | Corporate Director | Jun 1, 2020 | |
| Adp of the SNF | May 1, 2025 | ||
| Rhonda Dunham | Corporate Director | Jun 1, 2023 | |
| Adp of the SNF | May 1, 2026 | ||
| Claire Zajac | Corporate Director | Sep 1, 2021 | |
| Adp of the SNF | May 1, 2025 | ||
| Daniel Fahs | Corporate Director | Jun 1, 2024 | |
| Adp of the SNF | May 1, 2025 | ||
| Thomas Field | Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Christian Community Homes and Services Inc | Operational/Managerial Control | Jan 1, 1980 | |
| John Gerritts | Corporate Director | Jun 1, 2022 | |
| Adp of the SNF | May 1, 2025 | ||
| Craig Gibson | Corporate Director | Jun 1, 2022 | |
| Adp of the SNF | May 1, 2025 | ||
| Eric Johnson | Corporate Director | Sep 1, 2021 | |
| Adp of the SNF | May 1, 2025 | ||
| Aaron Mork | Corporate Director | Jun 1, 2023 | |
| Adp of the SNF | May 1, 2025 | ||
| Wintergreen Apartments, Inc. | Adp of the SNF | Apr 28, 2026 | |
| Debra Schwab | Corporate Director | Jun 1, 2021 | |
| Adp of the SNF | May 1, 2025 | ||
| Jennie Orman | 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.
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Baldwin, WI
- NPI 1336105840
Adp of the SNF, Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Baldwin Care Center | 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.
-
- Skilled Nursing Facility
- Osceola, WI
- NPI 1023391877
Christian Community Homes and Services Inc
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.
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Baldwin, WI
- NPI 1336105840
Affiliated clinicians 11
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Baldwin, WI
- NPI 1336105840
Nursing home
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.