Organization Active NPI

Edj LLC

  • Skilled Nursing Facility
  • Youngstown, OH
National Provider Identifier
1053308577
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0607N Issued in OH
Legal business name
EDJ LLC
Practice address
461 S Canfield Niles Rd
Youngstown, OH 44515-4022
Phone
(330) 270-3468
NPI assigned
Sep 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Authorized official

Name
Mrs. Diane J Reese
Title
Member/Adminastrator
Phone
(330) 270-3468

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 0607R OH
Skilled Nursing Facility 314000000X 0607N OH Primary

Addresses

Primary practice location

461 S Canfield Niles Rd
Youngstown, OH 44515-4022

Mailing address

461 S Canfield Niles Rd
Youngstown, OH 44515-4022
Phone (330) 270-3468

Other identifiers 3

IdentifierTypeStateIssuer
2438124MedicaidOH
000000324070OtherOHANTHEM
157021763OtherOHMEDICAID ASSISTANT LIVING WAIVER

Other names 1

  • BRIARFIELD MANOR Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211001009 OH Part A Provider - Skilled Nursing Facility 9032003967 Practice locations: Youngstown, OH

Skilled nursing facility certification: CCN 365822

Legal name
EDJ LLC
Doing business as
BRIARFIELD MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 28, 1990
Last certification
Mar 5, 2025
Beds
92
Ownership / control type
Corporation
Multi-facility organization
edm management
Most recent change of ownership
Jan 1, 2004
Organization structure
LLCProprietary
Enrollment address
461 S Canfield Niles Rd
Youngstown, OH 44515-4022
Nursing home name
BRIARFIELD MANOR

Care Compare: Nursing home

Medicare Care Compare
Listed as
Briarfield ManorCCN 365822
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 28, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9173.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Edj LLC2 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 38

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

NameRoleSinceShare
Manor Facility Realty LLC Organization, Boardman, OH LLC, Holding company Adp of the SNF Dec 31, 2003
Briana Rich Individual Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024
Edward J. Reese Family Trust I Organization, Canfield, OH Adp of the SNF May 1, 2021
Direct Ownership Interest May 1, 2021 50%
Indirect Ownership Interest May 1, 2021 50%
Individual Adp of the SNF Aug 31, 2015
Robert W Rupeka Individual Corporate OfficerChief Financial Officer Oct 1, 2013
Operational/Managerial Control Oct 1, 2013
Adp of the SNF Oct 1, 2013
Kristen McGuire Individual Operational/Managerial Control Mar 9, 2026
Adp of the SNF Mar 9, 2026
Individual Adp of the SNF Jun 15, 2021
Sudhir Kumar Nallapaneni Individual Adp of the SNF Aug 1, 2022
Individual Adp of the SNF Apr 1, 2025
Individual Adp of the SNF Aug 31, 2015
Kathyrn Young Individual Operational/Managerial Control Aug 1, 2022
Adp of the SNF Aug 1, 2022
Jennifer Cox Individual Operational/Managerial Control Dec 1, 2003
Adp of the SNF Dec 1, 2003
Deborah Smith Individual Operational/Managerial Control Sep 16, 2017
Adp of the SNF Sep 16, 2017
Joseph White Individual Operational/Managerial Control May 5, 2008
Adp of the SNF May 5, 2008
Individual Adp of the SNF Jan 1, 2004
Organization, Woodmere, OH LLC Adp of the SNF Jan 1, 2012
Individual Adp of the SNF Aug 31, 2015
Hill, Barth & King LLC Organization, Canfield, OH LLC Adp of the SNF Jan 1, 2004
Mary Beth Chaffin Individual Operational/Managerial Control Mar 16, 2023
Adp of the SNF Mar 16, 2023
Edward Reese Individual 5% Or Greater Direct Ownership Interest Jan 1, 2008 50%
Operational/Managerial Control Dec 1, 2003
Adp of the SNF Dec 1, 2003
Indirect Ownership Interest May 1, 2021 50%
Individual Adp of the SNF Apr 1, 2025
Amanda Rivera Individual Operational/Managerial Control Dec 16, 2020
Adp of the SNF Dec 16, 2020
Individual Adp of the SNF Jan 1, 2012
Edward Reese Individual Operational/Managerial Control Jul 13, 2010
Adp of the SNF Jul 13, 2010
Individual Adp of the SNF Apr 1, 2025
Kevin Ferguson Individual Operational/Managerial Control Nov 10, 2023
Adp of the SNF Nov 10, 2023
Farmers National Bank Canfield Organization, Canfield, OH Corporation, Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Aug 31, 2015 100%
Adp of the SNF Aug 31, 2015
Individual Adp of the SNF Jan 1, 2012
Individual Adp of the SNF Jan 1, 2012
Individual Adp of the SNF Jan 1, 2014
Wem & Associates, Inc Organization, Youngstown, OH Corporation, Consulting firm Adp of the SNF Jan 1, 2024
Edm Management, Inc Organization, Boardman, OH Corporation, Management services company Operational/Managerial Control Dec 1, 2003
Adp of the SNF Dec 1, 2003
Ovation Rehabilitation Services LLC Organization, Northville, MI LLC Operational/Managerial Control Apr 1, 2025
Adp of the SNF Apr 1, 2025
Diane J. Reese Family Trust I Organization, Canfield, OH Adp of the SNF May 1, 2021
Direct Ownership Interest May 1, 2021 50%
Diane Reese Individual 5% Or Greater Direct Ownership Interest Jan 1, 2008 50%
Operational/Managerial ControlAdministrator Dec 1, 2003
Adp of the SNF Dec 1, 2003
Indirect Ownership Interest May 1, 2021 50%
Amanda Mackie Individual Operational/Managerial Control Feb 16, 2023
Adp of the SNF Feb 16, 2023
Individual Adp of the SNF Jan 1, 2004
Individual Adp of the SNF Jan 1, 2004

Owners & managing parties with NPI records 1

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

Facilities with the same owner 2

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1053308577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 S CANFIELD NILES RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445154022",
            "telephone_number": "330-270-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 S CANFIELD NILES RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445154022",
            "telephone_number": "330-270-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER/ADMINASTRATOR",
        "authorized_official_telephone_number": "330-270-3468",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "0607R",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "0607N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2438124",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000324070",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ASSISTANT LIVING WAIVER",
            "identifier": "157021763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIARFIELD MANOR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BRIARFIELD MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.