NPIMap

Organization Active NPI

Souderton Mennonite Homes

  • Skilled Nursing Facility
  • Souderton, PA
National Provider Identifier
1871584409
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
050202 Issued in PA
Legal business name
SOUDERTON MENNONITE HOMES
Practice address
207 W Summit St
Souderton, PA 18964-2054
Phone
(215) 723-9881
Fax
(215) 723-1442
NPI assigned
Nov 2, 2005
Last updated
Apr 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Mr. Edward D. Brubaker
Title
Ceo
Phone
(215) 368-4438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 050202 PA Primary

Addresses

Primary practice location

207 W Summit St
Souderton, PA 18964-2054

Mailing address

207 W Summit St
Souderton, PA 18964-2054
Phone (215) 723-9881

Other identifiers 1

IdentifierTypeStateIssuer
0010170020001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090401000279 PA Part A Provider - Skilled Nursing Facility 0244397529 Practice locations: Souderton, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871584409. Details of each certification follow.

Skilled nursing facility certification: CCN 395634

Legal name
SOUDERTON MENNONITE HOMES
Doing business as
PATHS, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1984
Last certification
Mar 20, 2025
Beds
71
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Living Branches
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1916 in PA
Enrollment address
207 West Summit St
Souderton, PA 18964-2054
Nursing home name
SOUDERTON MENNONITE HOMES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Souderton Mennonite HomesCCN 395634 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 1, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7165.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0194107Souderton Mennonite Homes207 West Summit Street, Souderton, PA 18964Certificate of waiverAug 31, 2026
39D2207685Souderton Mennonite Homes Personal Care207 W Summit Street, Souderton, PA 18964Certificate of waiverDec 29, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 31

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

NameRoleSinceShare
Bryan Hunsberger Individual Corporate Director Nov 24, 2008
Friends Services for the Aging Organization, Blue Bell, PA Non-profit Operational/Managerial Control Jan 1, 2015
Adp of the SNF Nov 4, 2025
Physician and Tactical Healthcare Services LLC Organization, Cherry Hill, NJ LLC, Management services company Operational/Managerial Control Apr 1, 2012
Adp of the SNF Nov 4, 2025
Amy L Kolb Individual Corporate DirectorDirector Jan 31, 2017
General Health Care Resources, Inc. Organization, Blue Bell, PA LLC Adp of the SNF May 18, 2018
Joshua Josiah Meyer Individual Corporate DirectorDirector Jul 1, 2019
Baker Tilly US LLP Organization, Madison, WI Adp of the SNF May 10, 2016
Luke Jed Bergey Individual Corporate DirectorDirector Jul 1, 2020
Wellness Pharmacy Services LLC Organization, North Wales, PA LLC Adp of the SNF Feb 1, 2025
Nursing Care Services, Inc. Organization, Lansdale, PA Corporation, Medical staffing company Adp of the SNF Aug 21, 2017
Jill Arroyo Individual Operational/Managerial Control Mar 5, 2019
Adp of the SNF Mar 5, 2019
Lyle Kolb Individual Corporate Director Nov 24, 2008
John Oliver Gingrich Individual Corporate DirectorDirector Jul 1, 2021
James T Alderfer Individual Corporate DirectorDirector Nov 24, 2008
Theodore Gody Individual Operational/Managerial Control Jan 27, 2025
Adp of the SNF Jan 27, 2025
Edward Brubaker Individual Corporate DirectorPresident/Ceo Nov 24, 2008
Adp of the SNF Nov 24, 2008
Matevosyan Inc Organization, Delmont, PA Corporation, Medical staffing company Operational/Managerial Control Sep 13, 2013
Adp of the SNF Jun 28, 2017
Jane L Ruth Individual Corporate DirectorDirector Jan 31, 2017
Covenant Alliance Rehab East LLC Organization, Woodridge, IL LLC Adp of the SNF Oct 1, 2025
David Moore Individual Operational/Managerial Control Jan 15, 2024
Adp of the SNF Jan 15, 2024
Michael McCabe Individual Operational/Managerial Control Jun 9, 2021
Adp of the SNF Jun 9, 2021
Maura Ann Derstein Individual Corporate DirectorDirector Jul 1, 2024
Alexandra Metricarti Individual Operational/Managerial Control Apr 8, 2010
Adp of the SNF Apr 8, 2010
Wendell Weaver Individual Corporate DirectorDirector Jul 1, 2018
Living Branches Organization, Souderton, PA Corporation, Non-profit Operational/Managerial Control Nov 24, 2008
Daniel Haimowitz Individual Adp of the SNF Jan 1, 2014
John W Duerksen Individual Corporate DirectorDirector Jul 1, 2011
Steven D Myers Individual Operational/Managerial Control Sep 1, 2009
Adp of the SNF Sep 1, 2009
Titan Medical Group, LLC Organization, Omaha, NE LLC, Medical staffing company Adp of the SNF Feb 4, 2022
Monique Cole Individual Operational/Managerial Control Sep 5, 2017
Adp of the SNF Sep 5, 2017
Kristin Thim Individual Operational/Managerial Control Jan 21, 2020
Adp of the SNF Jan 21, 2020

Owners & managing parties with NPI records 3

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

Facilities with the same owner 21

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

View all 21

Practitioners & affiliated clinicians

Practitioners 6

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 11

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": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1871584409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W SUMMIT ST",
            "city": "SOUDERTON",
            "state": "PA",
            "postal_code": "189642054",
            "telephone_number": "215-723-9881",
            "fax_number": "215-723-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W SUMMIT ST",
            "city": "SOUDERTON",
            "state": "PA",
            "postal_code": "189642054",
            "telephone_number": "215-723-9881",
            "fax_number": "215-723-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUDERTON MENNONITE HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "BRUBAKER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-368-4438",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "050202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010170020001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Souderton, PA

Sources for this page

Verify at the official NPI Registry.