Church Homes, Inc. Congregational

Key facts

NPI: 1922092089
Entity type: Organization (NPI type 2)
Primary specialty: Home Health Agency 251E00000X
License: C9206305 (CT)
Legal business name: CHURCH HOMES, INC. CONGREGATIONAL
Practice address: 705 New Britain Ave
Hartford, CT 06106-4039
Phone: (860) 527-4663
NPI assigned: Sep 6, 2005
Organization subpart: Yes
Parent organization (as reported): CHURCH HOMES, INC. CONGREGATIONAL

Authorized official

Name: Mr. Patrick J Gilland
Title: President/Ceo
Phone: (860) 527-9126

Owners & managing parties with NPI records 2

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

Church Homes, Inc. Congregational Skilled Nursing Facility · Hartford, CT · NPI 1285628594

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · 5% OR GREATER SECURITY INTEREST
Church Homes, Inc. Congregational Skilled Nursing Facility · Salisbury, CT · NPI 1487648614

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · 5% OR GREATER SECURITY INTEREST

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Church Homes, Inc. Congregational Skilled Nursing Facility · Hartford, CT · NPI 1285628594

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · 5% OR GREATER SECURITY INTEREST

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Church Homes, Inc. Congregational Skilled Nursing Facility · Hartford, CT · NPI 1285628594

Same enrollment O20030930000025

Other NPIs with the same Medicare PAC ID 2

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

Church Homes, Inc. Congregational Skilled Nursing Facility · Hartford, CT · NPI 1285628594

Same PAC ID 0547172538
Church Homes, Inc. Congregational Skilled Nursing Facility · Salisbury, CT · NPI 1487648614

Same PAC ID 0547172538

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Church Homes, Inc. Congregational Skilled Nursing Facility · Salisbury, CT · NPI 1487648614

NPD tax ID

Practitioners 1

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

Joseph T Anquillare Sr., M.D. Geriatric Medicine (Internal Medicine) Physician · Hartford, CT · NPI 1316043045

NPD (past)

Medicare Care Compare: Home health agency

Listed as: Avery Heights Home Health Agency CCN 077182
Overall star rating: ★★☆☆☆ 2 of 5
Ownership: Proprietary
Certified: Oct 11, 1991
Medicare certification status: Active (Provider of Services file)
Services: Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CT

Home health agency certification: CCN 077182

Legal name: CHURCH HOMES, INC. CONGREGATIONAL
Doing business as: AVERY HEIGHTS HOME HEALTH AGENCY
Certification status: Active
Provider type (POS): Home health agency
Participating since: Oct 11, 1991
Last certification: Nov 27, 2019
Ownership / control type: Proprietary
Organization structure: Corporation · Non-profit
Incorporated: Dec 26, 1957 in CT
Enrollment address: 705 New Britain Ave
Hartford, CT 06106-4039
HHA Branch

All disclosed owners & managing parties 13

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

Name	Role	Since	Share
Cynthia J Martinez Individual	Corporate Officer Board Member	Jul 28, 2020
Church Homes, Inc. Congregational Organization · Hartford, CT Corporation, Non-profit	5% Or Greater Direct Ownership Interest	Dec 10, 1991	100%
	5% Or Greater Security Interest	Dec 10, 1991	100%
Cynthia W Shahen Individual	Corporate Officer Board Member	Nov 27, 2018
David E Canuel Individual	Corporate Officer Board Member	Sep 24, 2007
Patrick J Gilland Individual	Corporate Officer Ceo	Feb 19, 2001
Mercedese E Large Individual	Corporate Officer Board Memebr	Mar 23, 2009
Kenneth a McGovern Individual	Corporate Officer Board Member	Jul 28, 2020
Margaret a Golas Individual	Corporate Officer Board Member	Nov 27, 2018
P Wayne Moore Individual	Corporate Officer Board Member	Jul 28, 2020
Peter B Matthews Individual	Corporate Officer Board Member	Apr 23, 2007
Thomas P Kelley Individual	Corporate Officer Board Member	Jan 25, 2016
Larry C Brown Individual	Corporate Officer Board Member	May 26, 2020
Kerrie M Patumbo Individual	W-2 Managing Employee Administrator	Jun 27, 2016

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20030930000025	CT	Part a Provider - Home Health Agency	0547172538	1 other NPI on this enrollment Practice locations: Hartford, CT

National Provider Directory

Tax ID family: Avery Heights Medical G (2 organizations share this tax ID)
Part of: Avery Heights Medical G

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Health Agency	251E00000X	C9206305	CT	Yes

Addresses

Primary practice location

705 New Britain Ave
Hartford, CT 06106-4039

Mailing address

217 Avery HTS
Hartford, CT 06106-4271
Phone (860) 527-9126

Other identifiers

Identifier	Type	State	Issuer
004116308	Medicaid	CT

Other names

Avery Heights Home Health Agency Doing business as

Other providers in Hartford, CT

All providers in Hartford, CT · Home Health Agency in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2010. 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.

Verify at the official NPI Registry.