Organization Active NPI

Canton Christian Home, Inc

  • Skilled Nursing Facility
  • Canton, OH
National Provider Identifier
1982605507
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1618N Issued in OH
Legal business name
CANTON CHRISTIAN HOME, INC
Practice address
2550 Cleveland Ave NW
Canton, OH 44709-3306
Phone
(330) 456-0004
Fax
(330) 452-9951
NPI assigned
Aug 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Authorized official

Name
Mr. Thomas Strobl
Title
Administrator
Phone
(330) 456-0004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1618N OH Primary

Addresses

Primary practice location

2550 Cleveland Ave NW
Canton, OH 44709-3306

Mailing address

2550 Cleveland Ave NW
Canton, OH 44709-3306
Phone (330) 456-0004

Other identifiers 3

IdentifierTypeStateIssuer
0345237MedicaidOH
1618NOtherOHSTATE LICENSE NUMBER
1618ROtherOHRESCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805000550 OH Part A Provider - Skilled Nursing Facility 5597736132 Practice locations: Canton, OH

Skilled nursing facility certification: CCN 366300

Legal name
CANTON CHRISTIAN HOME INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 2004
Last certification
Mar 23, 2023
Beds
57
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
May 29, 1969 in OH
Enrollment address
2550 Cleveland Ave NW
Canton, OH 44709-3306
Nursing home name
CANTON CHRISTIAN HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Canton Christian HomeCCN 366300
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Sep 1, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5752.9 residents per day on average
Penalties (3 years)
1Fines totaling $9,113

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Canton Christian Home2 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 4

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

NameRoleSinceShare
Robert Nickoson Individual Corporate OfficerBoard Member Trustee May 20, 2015
Managing Control - Governing BodyBoard Member- President and Trustee May 20, 2015
Trustee of the SNF May 20, 2015
Adp of the SNF May 20, 2015
Heather Yoder Individual Corporate DirectorController Feb 6, 2018 50%
Adp of the SNF Feb 6, 2018
Janine S Stackhouse Individual Corporate DirectorExecutive Director Sep 28, 2023 100%
Operational/Managerial Control Sep 28, 2023
Adp of the SNF Sep 28, 2023
James Franz Individual Operational/Managerial Control Feb 6, 2018
Adp of the SNF Feb 6, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1982605507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093306",
            "telephone_number": "330-456-0004",
            "fax_number": "330-452-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093306",
            "telephone_number": "330-456-0004",
            "fax_number": "330-452-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON CHRISTIAN HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "STROBL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "330-456-0004",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1618N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345237",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1618N",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESCARE",
            "identifier": "1618R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.