St Croix Hospice LLC
Organization Active NPI Community Based Hospice Care Agency · Spirit Lake, IA
NPI 1659786259 · NPPES record last updated May 21, 2026
Key facts
- NPI
- 1659786259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- ST CROIX HOSPICE LLC
- Practice address
- 802 Lake St Ste 3
Spirit Lake, IA 51360-1660 - Phone
- (712) 264-5674
- Fax
- (712) 580-3043
- NPI assigned
- Jun 23, 2014
- Organization subpart
- No
Authorized official
- Name
- Stephen Phenneger
- Title
- Cfo and President
- Phone
- (612) 544-6133
Owners & managing parties with NPI records 2
-
Dale R Holdiman, MD
-
Andrew G Mayo, M.D.
Owned or controlled facilities with NPI records 24
Other NPIs with the same Medicare PAC ID 12
Corporate family (same tax ID) 13
Facilities with the same owner 36
Affiliated clinicians 79
-
Amir A Andrawis, M.D.
-
Amy Margreta Badberg, M.D.
-
Nicholas C. Bechtold, D.O.
-
William Bensen, D.O.
-
Zachary A Borus, MD
-
David H. Daniels, M.D.
-
Nicole L. Ehn, M.D.
-
Averill Fuhs, DO
-
Andrew J Geha, D.O.
-
Gregory W. Halbur, M.D.
-
Michael D. Harder, D.O.
-
Sheila Rae Holcomb, M.D.
-
Anna Ruth Holzer, MD
-
Jason A. Huisenga, D.O.
-
Amy C Jochims, M.D.
Medicare Care Compare: Hospice
- Listed as
- St Croix Hospice
- Ownership
- For-Profit
- Certified
- Mar 12, 2015
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2084594 | St Croix Hospice - Spirit Lake | Certificate of waiver | Sep 25, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Hospice certification: CCN 161607
- Legal name
- ST CROIX HOSPICE LLC
- Doing business as
- ST CROIX HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 12, 2015
- Last certification
- Dec 9, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 23, 2012 in MN
- Enrollment address
- 802 Lake St
Ste 3
Spirit Lake, IA 51360-1650
All disclosed owners & managing parties 25
| Name | Role | Since | Share |
|---|---|---|---|
| Melissa a Andrews |
Contracted Managing Employee |
Oct 24, 2025 | |
| Operational/Managerial Control |
Oct 24, 2025 | ||
| Qsuper Global Private Equity TR |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.04% |
| Antares Capital LP |
5% Or Greater Security Interest | Oct 30, 2020 | 100% |
| Andrew Graham Mayo |
W-2 Managing Employee |
Sep 29, 2014 | |
| Operational/Managerial Control |
Sep 29, 2014 | ||
| Stephen C Phenneger |
Corporate Officer |
Oct 29, 2020 | |
| Corporate Director |
Oct 29, 2020 | ||
| W-2 Managing Employee |
Oct 29, 2020 | ||
| Operational/Managerial Control |
Oct 29, 2020 | ||
| The State Public Sector |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.04% |
| TVG-STC Intermediate Corp |
5% Or Greater Indirect Ownership Interest | Sep 29, 2017 | 100% |
| STCH Acquisition Inc |
5% Or Greater Indirect Ownership Interest | Oct 30, 2020 | 100% |
| STCH Intermediate Inc |
5% Or Greater Indirect Ownership Interest | Oct 30, 2020 | 100% |
| Dale R Holdiman |
W-2 Managing Employee |
Feb 3, 2022 | |
| Operational/Managerial Control |
Feb 3, 2022 | ||
| Mandy L Cogswell |
W-2 Managing Employee |
Oct 1, 2017 | |
| Operational/Managerial Control |
Oct 1, 2017 | ||
| Hig STCH II LP |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 13.71% |
| 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% |
| Partners Group Access PF 882 LP |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 60.09% |
| Britany M Sundall |
W-2 Managing Employee |
Jun 15, 2021 | |
| Operational/Managerial Control |
Jun 15, 2021 | ||
| St Croix Hospice Acquisition Corp |
5% Or Greater Direct Ownership Interest | Oct 1, 2013 | 100% |
| STCH Parent Inc |
5% Or Greater Indirect Ownership Interest | Oct 30, 2020 | 100% |
| Heath a Bartness |
Corporate Officer |
Feb 28, 2013 | |
| Corporate Director |
Feb 28, 2013 | ||
| W-2 Managing Employee |
Feb 28, 2013 | ||
| Operational/Managerial Control |
Feb 28, 2013 | ||
| SCHP Midco Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Daintree Credit Co-Invest LP |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.04% |
| SCHP Intermediate Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Direct Equity V Eur |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.9% |
| SCHP Purchaser Inc |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Global Value Sicav |
5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 9.3% |
All facility ownership & control disclosures 24
| Facility | Type | Role | Since |
|---|---|---|---|
| St Croix Hospice Lombard |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 1, 2022 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jan 18, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 18, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Aug 1, 2022 |
| St Croix Hospice Des Plaines |
Hospice | Operational/Managerial Control | Jul 1, 2021 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jan 18, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St. Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Aug 1, 2022 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Aug 1, 2022 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St Croix Hospice Plymouth |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 29, 2022 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 15, 2022 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 5, 2023 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 5, 2023 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 5, 2023 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 28, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Dec 23, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Oct 28, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | May 22, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 28, 2024 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 29, 2025 |
| St Croix Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 29, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140915000260 | IA | Part a Provider - Hospice | 2264596121 | Practice locations: Humboldt, IA; Sioux City, IA; Spirit Lake, IA; Storm Lake, IA |
National Provider Directory
- Tax ID family
- St Croix Hospice LLC
Locations
1701 38th Ave W
Ste 100
Spencer, IA 51301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
802 Lake St Ste 3
Spirit Lake, IA 51360-1660
Mailing address
1175 Centre Pointe Cir
Mendota Heights, MN 55120-5500
Phone (651) 735-3656
Other names
- St. Croix Hospice
Other providers in Spirit Lake, IA
- Mark Steven Sorensen
- Spencer Municipal Hospital
- Spirit Lake C.S.D.
- Spirit Lake Chiropractic Clinic
- Spirit Lake Senior Operator, LLC
- Nicole Marie Stall
- Paige Nicole Steffen Frick
- Steven a Moore
- Still Waters Therapy
- Ami J. Swanson
All providers in Spirit Lake, IA · Community Based Hospice Care Agency in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 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.