Active NPI
Clinton Opco LLC
- Skilled Nursing Facility
- Clinton TWP, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CLINTON OPCO LLC
- Practice address
- 17001 17 Mile Rd
Clinton TWP, MI 48038-2801 - Phone
- (586) 286-7100
- Fax
- (586) 286-0802
- NPI assigned
- Oct 22, 2025
- Last updated
- Oct 22, 2025
- 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
- Tiffany M Lockhart
- Title
- Cfo
- Phone
- (330) 223-8200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
17001 17 Mile Rd
Clinton TWP, MI 48038-2801
Mailing address
17001 17 Mile Rd
Clinton TWP, MI 48038-2801
Phone (586) 286-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260306000928 | MI | Part A Provider - Skilled Nursing Facility | 8729560842 | Practice locations: Clinton Township, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1962379081. Details of each certification follow.
Skilled nursing facility certification: CCN 235405
- Legal name
- CLINTON OPCO LLC
- Doing business as
- HARMONY VILLAGE OF CLINTON
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1980
- Last certification
- Jun 4, 2025
- Beds
- 127
- Ownership / control type
- Corporation
- Multi-facility organization
- Mission Point
- Most recent change of ownership
- Nov 1, 2025
- Organization structure
- LLC
- Enrollment address
- 17001 17 Mile Road
Clinton Township, MI 48038-2801 - Nursing home name
- HARMONY VILLAGE OF CLINTON
- Affiliated entity
- CERTUS HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Harmony Village of Clinton
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 1, 1980
- Medicare certification status
- Active
- Certified beds
- 127
- Chain
- Certus Healthcare
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Ownership change
- Changed ownership in the last 12 months
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 |
|---|---|---|---|
| 23D0363871 | Clinton Opco LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 17
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 |
|---|---|---|---|
| JM and Mazel LLC | Adp of the SNF | Nov 1, 2025 | |
| Indirect Ownership Interest | Nov 1, 2025 | 7% | |
| Harmony Village Opco Holdco LLC | Direct Ownership Interest | Nov 1, 2025 | 100% |
| Shmuel Fishman | 5% Or Greater Indirect Ownership Interest | Nov 1, 2025 | 35.75% |
| Corporate Officer | Nov 1, 2025 | ||
| Adp of the SNF | Nov 1, 2025 | ||
| Joseph Orgel | 5% Or Greater Indirect Ownership Interest | Nov 1, 2025 | 14% |
| Adp of the SNF | Nov 1, 2025 | ||
| CHM Mi LLC | Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Nov 1, 2025 | ||
| Ebony Butler | Operational/Managerial Control | Nov 1, 2025 | |
| Gitberk Trust | Adp of the SNF | Nov 1, 2025 | |
| Indirect Ownership Interest | Nov 1, 2025 | 7% | |
| Gitberk LLC | Adp of the SNF | Nov 1, 2025 | |
| Indirect Ownership Interest | Nov 1, 2025 | 7% | |
| Harmony Village Propco Holdco LLC | Adp of the SNF | Nov 1, 2025 | |
| Mohammad Saleh | Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Jun 23, 2026 | ||
| JBL 120 Trust | Indirect Ownership Interest | Nov 1, 2025 | 7% |
| Indigo Michigan NH1 LLC | Adp of the SNF | Nov 1, 2025 | |
| Indirect Ownership Interest | Nov 1, 2025 | 35% | |
| Jason Dipasqua | 5% Or Greater Direct Ownership Interest | Nov 1, 2025 | 29.25% |
| Adp of the SNF | Nov 1, 2025 | ||
| Mazel Family Trust | Adp of the SNF | Nov 1, 2025 | |
| Indirect Ownership Interest | Nov 1, 2025 | 7% | |
| JBL 120 LLC | Adp of the SNF | Nov 1, 2025 | |
| Indirect Ownership Interest | Nov 1, 2025 | 7% | |
| Clinton Realty Holdings LLC | Adp of the SNF | Nov 1, 2025 | |
| Shayla Yopp-Carter | Operational/Managerial Control | Nov 1, 2025 | |
| Adp of the SNF | Jun 23, 2026 |
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
- Walled Lake, MI
- NPI 1619394004
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
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": "1761091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761091200000",
"number": "1962379081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17001 17 MILE RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480382801",
"telephone_number": "586-286-7100",
"fax_number": "586-286-0802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17001 17 MILE RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480382801",
"telephone_number": "586-286-7100",
"fax_number": "586-286-0802"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINTON OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-22",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A",
"authorized_official_last_name": "LOCKHART",
"authorized_official_first_name": "TIFFANY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "330-223-8200"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.