Organization Active NPI

Willow Brook Christian Services

Doing business as Cherith Care Center

  • Skilled Nursing Facility
  • Delaware, OH
National Provider Identifier
1811967078
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2085N3705 Issued in OH
Legal business name
WILLOW BROOK CHRISTIAN SERVICES
Doing business as
Cherith Care Center
Practice address
100 Willow Brook Way South
Delaware, OH 43015
Phone
(740) 369-0048
Fax
(740) 368-4630
NPI assigned
Jan 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Terry G Martini
Title
Finance Director
Phone
(740) 368-4621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2085N3705 OH Primary

Addresses

Primary practice location

100 Willow Brook Way South
Delaware, OH 43015

Mailing address

100 Willow Brook Way South
Delaware, OH 43015
Phone (740) 369-0048

Other identifiers 1

IdentifierTypeStateIssuer
2524138MedicaidOH

Other names 1

  • Cherith Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050128000560 OH Part A Provider - Skilled Nursing Facility 4486624970 Practice locations: Delaware, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811967078. Details of each certification follow.

Skilled nursing facility certification: CCN 366246

Legal name
WILLOW BROOK CHRISTIAN SERVICES
Doing business as
CHERITH CARE CENTER AT WILLOW BROOK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 2002
Last certification
May 28, 2025
Beds
34
Ownership / control type
Church Related
Multi-facility organization
Willow Brook Christian Services
Most recent change of ownership
Jan 1, 2005
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 2004 in OH
Enrollment address
100 Willow Brook S Way South
Delaware, OH 43015-3241
Nursing home name
CHERITH CARE CENTER AT WILLOW BROOK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cherith Care Center at Willow BrookCCN 366246 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Aug 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3431.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

55 Lazelle Rd
Columbus, OH 43235
Phone (614) 885-3300

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Scott Longo Individual Corporate DirectorBoard Member Mar 10, 2007
Managing Control - Governing BodyBoard Member Mar 10, 2007
Nicole Ketron Individual Operational/Managerial Control Jan 1, 2005
Adp of the SNF Jan 1, 2005
Dana Slingluff Individual Corporate DirectorBoard Member Mar 18, 2023
Managing Control - Governing BodyBoard Member Mar 18, 2023
Peter D Hucek Individual Adp of the SNF Jun 13, 2018
Thomas Poulson Individual Corporate OfficerChief Financial Officer Jun 28, 2010
Operational/Managerial Control Jun 28, 2010
Adp of the SNF Jun 28, 2010
Kim Johnson Individual Corporate DirectorBoard Member Nov 14, 2019
Managing Control - Governing BodyBoard Member Nov 14, 2019
Matthew Troy McKnight Individual Corporate OfficerCeo Jan 9, 2023
Operational/Managerial Control Jan 9, 2023
Adp of the SNF Jan 9, 2023
Jason Dulgar Individual Corporate DirectorBoard Member Nov 13, 2023
Managing Control - Governing BodyBoard Member Nov 13, 2023
Terry Lee Irwin Individual Corporate DirectorBoard Member Jan 1, 2005
Managing Control - Governing BodyBoard Member Jan 1, 2005
William Johnson Individual Corporate DirectorBoard Member Nov 14, 2019
Managing Control - Governing BodyBoard Member Nov 14, 2019
Brandi Davis Individual Corporate DirectorBoard Member Jan 11, 2024
Managing Control - Governing BodyBoard Member Jan 11, 2024
Blythe McKenna Individual Corporate DirectorBoard Member Jan 23, 2025
Managing Control - Governing BodyBoard Member Jan 23, 2025
Judy March Individual Corporate DirectorBoard Member Aug 10, 2017
Managing Control - Governing BodyBoard Member Aug 10, 2017
Roger Pickens Individual Corporate DirectorBoard Member Nov 8, 2012
Managing Control - Governing BodyBoard Member Nov 8, 2012
Peggy Tidwell Individual Corporate DirectorBoard Member Mar 16, 2013
Managing Control - Governing BodyBoard Member Mar 16, 2013
Ed Sarkel Individual Corporate DirectorBoard Member May 9, 2019
Managing Control - Governing BodyBoard Member May 9, 2019
Karen Susenna Individual Corporate DirectorBoard Member Nov 9, 2017
Managing Control - Governing BodyBoard Member Nov 9, 2017
Phil Barth Individual Corporate DirectorBoard Member Jan 1, 2005
Managing Control - Governing BodyBoard Member Jan 1, 2005

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811967078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLOW BROOK WAY SOUTH",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "43015",
            "telephone_number": "740-369-0048",
            "fax_number": "740-368-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLOW BROOK WAY SOUTH",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "43015",
            "telephone_number": "740-369-0048",
            "fax_number": "740-368-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BROOK CHRISTIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINI",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "740-368-4621",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2085N3705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2524138",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherith Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.