Alpena Opco LLC
Organization Active NPI Skilled Nursing Facility · Alpena, MI
NPI 1891211264 · NPPES record last updated May 28, 2026
Key facts
- NPI
- 1891211264
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- ALPENA OPCO LLC
- Practice address
- 301 Long Rapids Rd
Alpena, MI 49707-1317 - Phone
- (989) 356-2194
- NPI assigned
- Aug 17, 2017
- Organization subpart
- No
Authorized official
- Name
- Kristine Ranel Kirk
- Title
- Delegated Official
- Phone
- (417) 846-3521
Facilities with the same owner 77
Practitioners 2
-
David Dennis Dargis, D.O.
-
Raj Rao, M.D
Affiliated clinicians 2
-
David Dennis Dargis, D.O.
-
Raj Rao, M.D
Medicare Care Compare: Nursing home
- Listed as
- Medilodge of Alpena
- 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
- For profit - Individual
- Certified
- May 1, 1976
- Medicare certification status
- Active
- Certified beds
- 132 · 119.9 residents per day on average
- Chain
- Medilodge
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0669028 | Alpena Opco, LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Skilled nursing facility certification: CCN 235280
- Legal name
- ALPENA OPCO LLC
- Doing business as
- MEDILODGE OF ALPENA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 1976
- Last certification
- Aug 1, 2024
- Beds
- 132
- Ownership / control type
- Individual
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 25, 2017 in DE
- Enrollment address
- 301 Long Rapids Rd
Alpena, MI 49707-1317 - Nursing home name
- MEDILODGE OF ALPENA
- Affiliated entity
- MEDILODGE
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Cody Healthcare S Corp |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 47.55% |
| B&Y Trust |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 47.55% |
| Prestige Administrative Services, LLC |
Operational/Managerial Control | Jan 1, 2016 | |
| Blossom Healthcare Management LLC |
Operational/Managerial Control | Feb 1, 2018 | |
| Craig a Flashner |
Corporate Director | Feb 1, 2018 | |
| Operational/Managerial Control |
Feb 1, 2018 | ||
| Kristine Ranel Kirk |
W-2 Managing Employee |
Feb 1, 2018 | |
| Robert L Norcross |
Contracted Managing Employee |
Feb 1, 2018 | |
| Craig Flashner 2007 Trust |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 47.55% |
| B&Y Healthcare S Corp |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 47.55% |
| Stacey Paul Rogers |
Contracted Managing Employee |
Feb 1, 2018 | |
| Yitzchok a Perlstein |
Corporate Director |
Feb 1, 2018 | |
| Operational/Managerial Control |
Feb 1, 2018 | ||
| Everest Opco Group LLC |
5% Or Greater Direct Ownership Interest | Feb 1, 2018 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180213000594 | MI | Part a Provider - Skilled Nursing Facility | 2769742741 | Practice locations: Alpena, MI |
National Provider Directory
Locations
301 Long Rapids Rd
Alpena, MI 49707
Phone (989) 354-2194
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
301 Long Rapids Rd
Alpena, MI 49707-1317
Mailing address
7400 New la Grange Rd Ste 400
Louisville, KY 40222-4870
Phone (502) 429-8062
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891211264 | Medicaid | MI |
Other names
- Medilodge of Alpena
Other providers in Alpena, MI
- Alpena Health Multispecialty Clinic
- Alpena Medical Arts PC
- Alpena Medical Arts, P.C.
- Alpena Medical Arts, PC
- Alpena OB-GYN PC
- Alpena Orthopaedic Associates PLLC
- Alpena Radiology PC
- Alpena Redicare Walk-in Clinic, PLLC
- Alpena Regional Medical Center-BHS
- Alpena Surgical Associates, P.L.L.C.
All providers in Alpena, MI · Skilled Nursing Facility in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2026. 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.