Active NPI
Church of Christ Home for the Aged
- Skilled Nursing Facility
- Clinton Township, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 50-422
- Legal business name
- CHURCH OF CHRIST HOME FOR THE AGED
- Practice address
- 23575 15 Mile Rd
Clinton Township, MI 48035-3108 - Phone
- (586) 791-2470
- Fax
- (586) 791-2475
- NPI assigned
- Aug 7, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gerald L Berger
- Title
- Director of Finance
- Phone
- (586) 791-2470
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 50-422 | MI | Primary |
Addresses
Primary practice location
23575 15 Mile Rd
Clinton Township, MI 48035-3108
Mailing address
23575 15 Mile Rd
Clinton Township, MI 48035-3108
Phone (586) 791-2470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2153528 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060125000130 | MI | Part A Provider - Skilled Nursing Facility | 0547284945 | Practice locations: Clinton Township, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1932118718. Details of each certification follow.
Skilled nursing facility certification: CCN 235619
- Legal name
- CHURCH OF CHRIST HOME FOR THE AGED
- Doing business as
- CHURCH OF CHRIST CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 24, 2006
- Last certification
- Aug 1, 2024
- Beds
- 129
- Ownership / control type
- Church Related
- Organization structure
- Corporation
- Enrollment address
- 23575 15 Mile Rd
Clinton Township, MI 48035-3108 - Nursing home name
- CHURCH OF CHRIST CARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Church of Christ Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Feb 24, 2006
- Medicare certification status
- Active
- Certified beds
- 129
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0363691 | Church of Christ Care Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
23575 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-7116
Ownership & related parties
All disclosed owners & managing parties 20
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 |
|---|---|---|---|
| Lenora Hardyfoster | Corporate Director | Feb 13, 2020 | |
| Trustee of the SNF | Feb 13, 2020 | ||
| Adp of the SNF | Feb 12, 2025 | ||
| Janet Olafsson | Operational/Managerial Control | Sep 19, 2022 | |
| Adp of the SNF | Oct 22, 2019 | ||
| Michael Messier | Trustee of the SNF | Feb 14, 2006 | |
| Adp of the SNF | Feb 12, 2025 | ||
| Adp of the SNF | Feb 12, 2025 | ||
| Adp of the SNF | Feb 12, 2025 | ||
| Debra Arnett | Trustee of the SNF | Mar 27, 2018 | |
| Adp of the SNF | Feb 12, 2025 | ||
| Patti Jenema | Operational/Managerial Control | Oct 1, 2021 | |
| Adp of the SNF | Oct 1, 2021 | ||
| Adp of the SNF | Feb 12, 2025 | ||
| Basem Almasri | Operational/Managerial Control | Aug 7, 2009 | |
| Adp of the SNF | Aug 7, 2009 | ||
| Adp of the SNF | Feb 12, 2025 | ||
| John Swantek | Trustee of the SNF | Feb 14, 2006 | |
| Adp of the SNF | Feb 12, 2025 | ||
| Mark David Wilson | Trustee of the SNF | Feb 14, 2006 | |
| Jenel Stoinski | Operational/Managerial Control | Jan 2, 2025 | |
| Adp of the SNF | Jan 3, 2025 | ||
| Adp of the SNF | Feb 12, 2025 | ||
| David Kelly Stewart | Corporate Director | Oct 22, 2019 | 100% |
| Adp of the SNF | Oct 22, 2019 | ||
| Adp of the SNF | Feb 12, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Roseville, MI
- NPI 1326040510
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Roseville, MI
- NPI 1326040510
Affiliated clinicians 1
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": "1154908800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1932118718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23575 15 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480353108",
"telephone_number": "586-791-2470",
"fax_number": "586-791-2475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23575 15 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480353108",
"telephone_number": "586-791-2470",
"fax_number": "586-791-2475"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHURCH OF CHRIST HOME FOR THE AGED",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BERGER",
"authorized_official_first_name": "GERALD",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "DIRECTOR OF FINANCE",
"authorized_official_telephone_number": "586-791-2470",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"license": "50-422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2153528",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.