Beaumont Ashn, LLC
Organization Active NPI Community Based Hospice Care Agency · Troy, MI
NPI 1851865786 · NPPES record last updated Dec 27, 2021
Key facts
- NPI
- 1851865786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- BEAUMONT ASHN, LLC
- Practice address
- 1975 Technology Dr # J120
Troy, MI 48083-4247 - Phone
- (248) 743-9400
- NPI assigned
- Jan 14, 2019
- Organization subpart
- No
Authorized official
- Name
- Debbie Kirschman
- Title
- VP Legal Affairs
- Phone
- (937) 299-1111
Owners & managing parties with NPI records 13
-
John Hosford Cooke, D.O.
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Change of ownership 1
Facilities with the same owner 20
Affiliated clinicians 2
-
Malaz Alatassi, M.D.
Medicare Care Compare: Hospice
- Listed as
- Beaumont Hospice
- Ownership
- For-Profit
- Certified
- May 7, 1996
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Hospice certification: CCN 231574
- Legal name
- BEAUMONT ASHN LLC
- Doing business as
- BEAUMONT HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 7, 1996
- Last certification
- Mar 12, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 31, 2019 in OH
- Enrollment address
- 1975 Technology Dr
Ste J120
Troy, MI 48083-4247
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Kelli Martin |
W-2 Managing Employee |
May 1, 2023 | |
| Alternate Solutions Holdings Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 50.5% |
| Everett Neal |
Corporate Officer |
Apr 1, 2022 | |
| Michigan Hhah Holdings LLC |
5% Or Greater Direct Ownership Interest | Jan 1, 2019 | 100% |
| Ashn Midco LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 90% |
| Irrevocable Trust Tessie Ganzsarto |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 6.31% |
| John H Cooke |
Corporate Director |
Apr 15, 2024 | |
| Alternate Solutions Health Network LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 90% |
| General Atlantic (As) Collections LP |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 35.8% |
| Ashn Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 90% |
| Alternate Solutions Healthcare Southeast Michigan LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 90% |
| The Warren D. Ganzsarto Amended Revocable Living Trust |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 47.31% |
| William Beaumont Hospital |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 10% |
| Warren David Ganzsarto |
5% Or Greater Indirect Ownership Interest |
Jan 1, 2019 | 47.31% |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jan 1, 2019 | Change of Ownership |
Beaumont Hospice |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190225000024 | MI | Part a Provider - Hospice | 8820337504 | Practice locations: Troy, MI |
National Provider Directory
- Tax ID family
- Beaumont Ashn LLC
Locations
1975 Technology Dr
Ste J120
Troy, MI 48083
Phone (248) 743-9400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
1975 Technology Dr # J120
Troy, MI 48083-4247
Mailing address
1050 Forrer Blvd
Kettering, OH 45420-1472
Phone (937) 299-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1563088 | Medicaid | MI |
Other names
- Beaumont Home Health and Hospice, LLC
- Beaumont Hospice
Other providers in Troy, MI
- Donald Samuel Beam III
- Latoya Beard
- Christina Bearre
- Pamela Beattie
- Beaumont Ashn, LLC
- Beaumont Medical Group- Specialty Services
- Sarah Nicole Beaupre
- Justine Alexandra Beauvais-Niezurawski
- Alexandria Nicole Beavers
- Becker Orthopedic Appliance Company
All providers in Troy, MI · Community Based Hospice Care Agency in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2021. 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.