Care at Home by Green Hills LLC
Organization Active NPI Community Based Hospice Care Agency · Bellefontaine, OH
NPI 1720142573 · NPPES record last updated Mar 13, 2020
Key facts
- NPI
- 1720142573
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 0022HSP (OH)
- Legal business name
- CARE AT HOME BY GREEN HILLS LLC
- Practice address
- 921 Rush Ave
Bellefontaine, OH 43311-2358 - Phone
- (937) 599-4940
- NPI assigned
- Dec 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Stephanie Christopher
- Title
- Cfo
- Phone
- (937) 465-5065
Owners & managing parties with NPI records 1
-
Charles V. Kratz, M.D.
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Facilities with the same owner 22
Affiliated clinicians 1
-
Charles V. Kratz, M.D.
Medicare Care Compare: Hospice
- Listed as
- Universal Home Health & Hospice
- Ownership
- Non-Profit
- Certified
- Oct 16, 1990
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Hospice certification: CCN 361550
- Legal name
- CARE AT HOME BY GREEN HILLS LLC
- Doing business as
- OTTERBEIN UNIVERSAL HOME HEALTH & HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 16, 1990
- Last certification
- Jul 15, 2021
- Ownership / control type
- Non-Profit - Private
- Organization structure
- LLC · Non-profit
- Incorporated
- Sep 7, 2012 in OH
- Enrollment address
- 921 Rush Ave
Bellefontaine, OH 43311
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Otterbein LSC, LLC |
5% Or Greater Indirect Ownership Interest | Dec 23, 2024 | 100% |
| Charles Vernon Kratz |
W-2 Managing Employee |
Mar 10, 2010 | |
| Jill Wilson |
Corporate Officer |
Dec 23, 2024 | 1% |
| Otterbein Green Hills Foundation, Inc. |
5% Or Greater Direct Ownership Interest | Dec 1, 2016 | 100% |
| Michael Ray |
Corporate Officer |
Dec 1, 2016 | |
| W-2 Managing Employee |
Dec 23, 2024 | ||
| Otterbein Home |
5% Or Greater Indirect Ownership Interest | Dec 23, 2024 | 100% |
| James Christopher Green |
Corporate Officer |
Dec 23, 2024 | 1% |
| Karen Schlinglof |
W-2 Managing Employee |
Aug 1, 2020 | |
| Amber Swords |
Corporate Director |
May 23, 2022 | |
| W-2 Managing Employee |
Dec 23, 2024 | 1% |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Dec 1, 2016 | Change of Ownership |
Universal Home Health and Hospice Care Inc |
| Dec 1, 2016 | Change of Ownership |
Otterbein Universal Home Health & Hospice |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170222000970 | OH | Part a Provider - Hospice | 8022261908 | Practice locations: Bellefontaine, OH |
National Provider Directory
- Tax ID family
- Care at Home by Green Hills LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 0022HSP | OH | Yes |
Addresses
Primary practice location
921 Rush Ave
Bellefontaine, OH 43311-2358
Mailing address
921 Rush Ave
Bellefontaine, OH 43311-2358
Phone (937) 599-4940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2701428 | Medicaid | OH |
Other names
- Universal Home Health & Hospice
Other providers in Bellefontaine, OH
- Jinwon Byun
- C and G Eyecare LLC
- Kristina Caine
- Cancer Network of West Central Ohio
- Care at Home by Green Hills LLC
- Nicole Carson
- Trisha Ann Carson
- Michelle Cartellone
- Brittany Case
- Angie Marlene Castle
All providers in Bellefontaine, OH · Community Based Hospice Care Agency in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. 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.