NPIMap

Organization Active NPI

Friendship Village of Mill Creek

  • Skilled Nursing Facility
  • Geneva, IL
National Provider Identifier
1922347293
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0050286 Issued in IL
Legal business name
FRIENDSHIP VILLAGE OF MILL CREEK
Practice address
0N801 Friendship Way
Geneva, IL 60134-6206
Phone
(630) 578-6500
Fax
(630) 938-7800
NPI assigned
Feb 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Authorized official

Name
Mr. Michael A Flynn
Title
Vice Pres & Chief Executive Officer
Phone
(847) 884-5371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 5103954 IL
Skilled Nursing Facility 314000000X 0050286 IL Primary

Addresses

Primary practice location

0N801 Friendship Way
Geneva, IL 60134-6206

Mailing address

0N801 Friendship Way
Geneva, IL 60134-6206
Phone (630) 578-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130829000019 IL Part A Provider - Skilled Nursing Facility 7315180957 Practice locations: Geneva, IL

Skilled nursing facility certification: CCN 146166

Legal name
FRIENDSHIP VILLAGE OF MILL CREEK
Doing business as
GREENFIELDS OF GENEVA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 13, 2013
Last certification
Nov 8, 2024
Beds
43
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 27, 2005 in IL
Enrollment address
0N801 Friendship Way
Geneva, IL 60134-6206
Nursing home name
GREENFIELDS OF GENEVA
Affiliated entity
LIFESPACE COMMUNITIES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Greenfields of GenevaCCN 146166
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Dec 13, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4342.2 residents per day on average
Chain
Lifespace Communities15 facilities in the chain
Penalties (3 years)
1Fines totaling $14,203

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Friendship Village of Mill Creek2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Nicholas Harshfield Individual Corporate OfficerTreasurer Feb 1, 2023
Corporate DirectorVice Chairman Feb 1, 2023
Lifespace Communities Inc Organization, West Des Moines, IA Corporation, Non-profit Operational/Managerial Control Feb 1, 2023 100%
Elijah Heyboer Individual W-2 Managing Employee Jul 1, 2023
Erin Pope Individual Corporate OfficerChief Compliance Officer & Dep. GC Feb 1, 2023
Jesse Jantzen Individual Corporate OfficerPresident and Ceo Feb 1, 2023
Corporate DirectorChairman Feb 1, 2023
Brian Robbins Individual Corporate Director Feb 1, 2023
Joseph T Gorman Individual Corporate OfficerSecretary Feb 1, 2023

Owners & managing parties with NPI records 10

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

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

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": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1922347293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0N801 FRIENDSHIP WAY",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346206",
            "telephone_number": "630-578-6500",
            "fax_number": "630-938-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "0N801 FRIENDSHIP WAY",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346206",
            "telephone_number": "630-578-6500",
            "fax_number": "630-938-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDSHIP VILLAGE OF MILL CREEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRES & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "847-884-5371",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "5103954",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0050286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.