Family Home Health LP
Organization Active NPI Community Based Hospice Care Agency · Monroeville, PA
NPI 1669986824 · NPPES record last updated Sep 12, 2019
Key facts
- NPI
- 1669986824
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- FAMILY HOME HEALTH LP
- Practice address
- 300 Oxford Dr Ste 200
Monroeville, PA 15146-2398 - Phone
- (412) 856-4000
- Fax
- (412) 373-6877
- NPI assigned
- Nov 27, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- SUGAR CREEK REST, INC.
Authorized official
- Name
- Dean Rippee
- Title
- Cfo
- Phone
- (724) 431-0770
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Change of ownership 1
Facilities with the same owner 7
Practitioners 2
-
Devin Novak, P.T.
Affiliated clinicians 19
-
Andrew Curtis Adams, M.D.
-
Silvia E Coleman, MD
-
Nora Flores-Paras, M.D.
-
Gregory Anthony George, M.D.
-
Joseph Randy Kalik, D.O.
-
Jerzy K Magda, MD
-
Robert N Moses, M.D.
-
Michele Ann Oleksak, M.D.
-
Hany Sadek Rezk, MD
-
Jerome E Scherer, DO
-
Rachel Ann Shipley, M.D.
-
David R Shober, DO
-
Jarod Paul Stragand, D.O.
-
Timothy Lockso, D.O.
Medicare Care Compare: Hospice
- Listed as
- Three Rivers Hospice
- Ownership
- For-Profit
- Certified
- Dec 14, 2005
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Hospice certification: CCN 391670
- Legal name
- FAMILY HOME HEALTH LP
- Doing business as
- THREE RIVERS HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 14, 2005
- Last certification
- Feb 3, 2022
- Ownership / control type
- Proprietary - Partnership
- Organization structure
- Partnership · Proprietary
- Incorporated
- Jun 26, 2017 in PA
- Enrollment address
- 300 Oxford Dr
Ste 200
Monroeville, PA 15146-2398
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Paula J Minnicks |
W-2 Managing Employee |
Feb 1, 2018 | |
| Steven D Tack Irrevocable Trust |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 33% |
| Mary Susan Tack-Yurek Irrevocable Trust |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 33% |
| Kevin M Wong |
W-2 Managing Employee |
Feb 1, 2018 | |
| Susan Tack Beardsley Irrevocable Trust |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 33% |
| Marilyn Cornman |
Corporate Director |
Aug 1, 2022 | 100% |
| Susan E Tack-Beardsley |
Other |
Feb 1, 2018 | 33.3% |
| Mary S Tack-Yurek |
Other |
Feb 1, 2018 | |
| Tack Family Ventures LLC |
Limited Partnership Interest | Jun 26, 2017 | 99% |
| Sugar Creek Rest Inc |
General Partnership Interest | Jun 26, 2017 | 1% |
| Operational/Managerial Control | Feb 1, 2018 | ||
| Steven D Tack |
Other |
Feb 1, 2018 | |
| Michael Markivich |
Corporate Officer |
Jul 26, 2023 | 100% |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Feb 1, 2018 | Change of Ownership |
Three Rivers Hospice |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180212000373 | PA | Part a Provider - Hospice | 7012277213 | Practice locations: Monroeville, PA; New Castle, PA |
National Provider Directory
- Tax ID family
- Family Home Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | PA | Yes |
Addresses
Primary practice location
300 Oxford Dr Ste 200
Monroeville, PA 15146-2398
Mailing address
612 N Main St
Butler, PA 16001-4363
Phone (724) 431-0770
Other names
- Quality Life Services, Inc.
- family home health and three rivers hospice
Other providers in Monroeville, PA
- Facial Surgery Center of Monroeville LLC
- Nosheen Fahd
- Carla T Falcon
- Michele Falcon
- Richard Mario Falcone II
- Family Home Health LP
- Family Home Health Services, Inc.
- Family Recovery, LLC
- Ben Farrar
- Carrie Ann Farrow
All providers in Monroeville, PA · Community Based Hospice Care Agency in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2019. 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.