Organization Active NPI

Cliffside Company L L C

  • Nursing Facility/Intermediate Care Facility
  • Saint Joseph, MI
National Provider Identifier
1801962097
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
114184 Issued in MI
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

Updated by the provider on Feb 18, 2025

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
09937OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Coventry House Inn Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
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 IDStateProvider typePAC IDDetails
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
LLCProprietary
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 InnCCN 235605 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 14, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3228.7 residents per day on average
Chain
Symphony Care Network7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Benoit Holdings LLC Organization, Lincolnwood, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2019 20%
Mary Ziomkowski Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2019 20%
W-2 Managing EmployeeFacility Administrator Jan 1, 2022
Calumet South LLC Organization, Lincolnwood, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2019 5%
Fairhome Trust Uad 12312012 Organization, Lincolnwood, IL 5% Or Greater Indirect Ownership Interest Sep 1, 2019 20%
Willow Delta Trust Organization, Lincolnwood, IL 5% Or Greater Indirect Ownership Interest Sep 1, 2019 15%
David Hartman Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2019 30%
Corporate OfficerCeo Sep 1, 2019
Operational/Managerial ControlManager, Ceo, Cho Adminstrator Sep 1, 2019
GZLT Holdings LLC Organization, Lincolnwood, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2019 10%
Truist Organization, Atlanta, GA Financial institution 5% Or Greater Security Interest Sep 1, 2019
Drake Louis Enterprise, LLC Organization, Lincolnwood, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2019 30%
Yossi Senderowicz Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2019 5%
Aria Consulting Services LLC Organization, Lincolnwood, IL LLC, For-profit Operational/Managerial Control Sep 1, 2019
Symphony of Michigan Holdings LLC Organization, Lincolnwood, IL LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2019 100%
Mark Hartman Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2019 20%
Ari P Krupp Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2019 10%
Corporate OfficerCfo Sep 1, 2019
Operational/Managerial ControlCfo Sep 1, 2019

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

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

Verify at the official NPI Registry.