Active NPI
Cliffside Company L L C
- Nursing Facility/Intermediate Care Facility
- Saint Joseph, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 114184
- Legal business name
- CLIFFSIDE COMPANY L L C
- Doing business as
- Coventry House Inn
- Practice address
- 3905 Lorraine Path
Saint Joseph, MI 49085-8630 - Phone
- (269) 428-1111
- Fax
- (269) 556-9684
- NPI assigned
- Nov 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David J Hartman
- Title
- Owner
- Phone
- (773) 259-1600
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 114184 | MI | Primary |
| Skilled Nursing Facility | 314000000X | 1070000420 | MI |
Addresses
Primary practice location
3905 Lorraine Path
Saint Joseph, MI 49085-8630
Mailing address
910 S Washington Ave
Royal Oak, MI 48067-3216
Phone (248) 543-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09937 | Other | MI | BLUE CROSS BLUE SHIELD |
Other names 1
- Coventry House Inn
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030801000017 | MI | Part A Provider - Skilled Nursing Facility | 0244141943 | Practice locations: Saint Joseph, MI |
Skilled nursing facility certification: CCN 235605
- Legal name
- CLIFFSIDE COMPANY LLC
- Doing business as
- COVENTRY HOUSE INN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Mar 14, 2003
- Last certification
- Dec 5, 2024
- Beds
- 32
- Ownership / control type
- Corporation
- Multi-facility organization
- Symphony Care Network
- Organization structure
- LLC
- Incorporated
- Jun 23, 1999 in MI
- Enrollment address
- 3905 Lorraine Path
Saint Joseph, MI 49085-8630 - Nursing home name
- COVENTRY HOUSE INN
- Affiliated entity
- SYMPHONY CARE NETWORK
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Coventry House Inn
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 14, 2003
- Medicare certification status
- Active
- Certified beds
- 32
- Chain
- Symphony Care Network
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
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 |
|---|---|---|---|
| Benoit Holdings LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 20% |
| Mary Ziomkowski | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 20% |
| W-2 Managing Employee | Jan 1, 2022 | ||
| Calumet South LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 5% |
| Fairhome Trust Uad 12312012 | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 20% |
| Willow Delta Trust | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 15% |
| David Hartman | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 30% |
| Corporate Officer | Sep 1, 2019 | ||
| Operational/Managerial Control | Sep 1, 2019 | ||
| GZLT Holdings LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 10% |
| Truist | 5% Or Greater Security Interest | Sep 1, 2019 | |
| Drake Louis Enterprise, LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 30% |
| Yossi Senderowicz | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 5% |
| Aria Consulting Services LLC | Operational/Managerial Control | Sep 1, 2019 | |
| Symphony of Michigan Holdings LLC | 5% Or Greater Direct Ownership Interest | Sep 1, 2019 | 100% |
| Mark Hartman | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 20% |
| Ari P Krupp | 5% Or Greater Indirect Ownership Interest | Sep 1, 2019 | 10% |
| Corporate Officer | Sep 1, 2019 | ||
| Operational/Managerial Control | Sep 1, 2019 |
Facilities with the same owner 7
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Woodhaven, MI
- NPI 1063586923
Aria Consulting Services LLC, Benoit Holdings LLC, Calumet South LLC, Drake Louis Enterprise, LLC, Fairhome Trust Uad 12312012, GZLT Holdings LLC, Symphony of Michigan Holdings LLC, Willow Delta Trust
-
- Skilled Nursing Facility
- Brighton, MI
- NPI 1275609877
Benoit Holdings LLC, Calumet South LLC, Drake Louis Enterprise, LLC, Fairhome Trust Uad 12312012, GZLT Holdings LLC, Symphony of Michigan Holdings LLC, Willow Delta Trust
-
- Skilled Nursing Facility
- Bay City, MI
- NPI 1881755262
Benoit Holdings LLC, Calumet South LLC, Drake Louis Enterprise, LLC, Fairhome Trust Uad 12312012, GZLT Holdings LLC, Symphony of Michigan Holdings LLC, Willow Delta Trust
-
- Skilled Nursing Facility
- Linden, MI
- NPI 1730386665
Benoit Holdings LLC, Calumet South LLC, Drake Louis Enterprise, LLC, Fairhome Trust Uad 12312012, GZLT Holdings LLC, Symphony of Michigan Holdings LLC, Willow Delta Trust
-
- Skilled Nursing Facility
- Dyer, IN
- NPI 1427834597
Drake Louis Enterprise, LLC
-
- Skilled Nursing Facility
- Belvidere, IL
- NPI 1427325778
Drake Louis Enterprise, LLC, Willow Delta Trust
-
- Skilled Nursing Facility
- Belvidere, IL
- NPI 1407124811
Drake Louis Enterprise, LLC, Willow Delta Trust
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Portage, MI
- NPI 1295965499
-
- Family Medicine Physician
- Bridgman, MI
- NPI 1669499257
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Saint Joseph, MI
- NPI 1871370551
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739836800000",
"number": "1801962097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 S WASHINGTON AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480673216",
"telephone_number": "248-543-7300",
"fax_number": "248-399-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 LORRAINE PATH",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490858630",
"telephone_number": "269-428-1111",
"fax_number": "269-556-9684"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLIFFSIDE COMPANY L L C",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-28",
"last_updated": "2025-02-18",
"certification_date": "2025-02-17",
"status": "A",
"authorized_official_last_name": "HARTMAN",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "773-259-1600"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "MI",
"license": "114184",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"license": "1070000420",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "09937",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1066.1",
"affiliationName": "eSolutions Inc",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CVS",
"address_1": "1506 Taylor Plz E",
"city": "Garden City",
"state": "KS",
"country_code": "US",
"postal_code": "678464055",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Coventry House Inn",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.