Quality Life Services - Sugar Creek, LLC
Organization Active NPI Skilled Nursing Facility · Worthington, PA
NPI 1659146355 · NPPES record last updated Nov 22, 2023
Key facts
- NPI
- 1659146355
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- QUALITY LIFE SERVICES - SUGAR CREEK, LLC
- Practice address
- 120 Lakeside Dr
Worthington, PA 16262-5102 - Phone
- (724) 445-3000
- NPI assigned
- Nov 22, 2023
- Organization subpart
- No
Authorized official
- Name
- Steven D. Tack
- Title
- President/Ceo
- Phone
- (724) 431-0770
Owners & managing parties with NPI records 1
Practitioners 3
Affiliated clinicians 3
Medicare Care Compare: Nursing home
- Listed as
- Quality Life Services - Sugar Creek
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 6, 1978
- Medicare certification status
- Active
- Certified beds
- 114 · 108.4 residents per day on average
- Chain
- Quality Life Services
- Penalties (3 years)
- 3 · fines totaling $246,480
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0884028 | Quality Life SVCS - Sugar Creek | Certificate of waiver | Mar 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Skilled nursing facility certification: CCN 395410
- Legal name
- QUALITY LIFE SERVICES - SUGAR CREEK, LLC
- Doing business as
- QUALITY LIFE SERVICES - SUGAR CREEK
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 6, 1978
- Last certification
- May 16, 2025
- Beds
- 114
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Quality Life Services
- Organization structure
- LLC · Proprietary
- Enrollment address
- 120 Lakeside Drive
Worthington, PA 16262-5102 - Nursing home name
- QUALITY LIFE SERVICES - SUGAR CREEK
- Affiliated entity
- QUALITY LIFE SERVICES
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Tonia M Kania |
Adp of the SNF | Mar 1, 2024 | |
| Sugar Creek Rest, Inc |
Adp of the SNF | Sep 15, 2025 | |
| Encova Mutual Insurance Group Inc |
Adp of the SNF | May 9, 2025 | |
| Lawrence Nicholas |
Operational/Managerial Control | Mar 1, 2024 | |
| Adp of the SNF | Sep 15, 2025 | ||
| First National Insurance Agency |
Adp of the SNF | May 9, 2025 | |
| Richard a Mercurio |
Adp of the SNF | Mar 1, 2024 | |
| Christine Carter |
Adp of the SNF | Mar 1, 2024 | |
| Susan E Tack-Beardsley |
Operational/Managerial Control | Mar 1, 2024 | |
| Lisa Stafford |
Adp of the SNF | Mar 1, 2024 | |
| Mary S Tack-Yurek |
Operational/Managerial Control | Mar 1, 2024 | |
| Steven D Tack |
Operational/Managerial Control | Mar 1, 2024 | |
| Bonnie Lopiccolo |
Adp of the SNF | Mar 1, 2024 | |
| Michael Markivich |
Operational/Managerial Control | Mar 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240731000156 | PA | Part a Provider - Skilled Nursing Facility | 9436696150 | Practice locations: Worthington, PA |
National Provider Directory
Locations
612 N Main St
Butler, PA 16001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
120 Lakeside Dr
Worthington, PA 16262-5102
Mailing address
612 N Main St
Butler, PA 16001-4363
Phone (724) 431-0770
Other names
- Quality Life Services - Sugar Creek
Other providers in Worthington, PA
- Cheryl Brochetti
- Nelson Brocious
- Amber Elaine Crownover
- Paul Richard Daisley
- JLR PC Adam Associates
- Brandon Snickles
- Sugar Creek Rest, LTD PTR
- Kristina Sue Totin
- Joyce Witkiewicz-Bowser
All providers in Worthington, PA · Skilled Nursing Facility in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2023. 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.