Active NPI
Edj LLC
- Skilled Nursing Facility
- Youngstown, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0607N
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2438124 | Medicaid | OH | |
| 000000324070 | Other | OH | ANTHEM |
| 157021763 | Other | OH | MEDICAID ASSISTANT LIVING WAIVER |
Other names 1
- BRIARFIELD MANOR
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Manor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Nov 28, 1990
- Medicare certification status
- Active
- Certified beds
- 91
National Provider Directory
National Provider Directory- Tax ID family
- Edj LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Austintown, OH
- NPI 1639959992
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Manor Facility Realty LLC | Adp of the SNF | Dec 31, 2003 | |
| Briana Rich | Operational/Managerial Control | Oct 1, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Edward J. Reese Family Trust I | Adp of the SNF | May 1, 2021 | |
| Direct Ownership Interest | May 1, 2021 | 50% | |
| Indirect Ownership Interest | May 1, 2021 | 50% | |
| Adp of the SNF | Aug 31, 2015 | ||
| Robert W Rupeka | Corporate Officer | Oct 1, 2013 | |
| Operational/Managerial Control | Oct 1, 2013 | ||
| Adp of the SNF | Oct 1, 2013 | ||
| Kristen McGuire | Operational/Managerial Control | Mar 9, 2026 | |
| Adp of the SNF | Mar 9, 2026 | ||
| Adp of the SNF | Jun 15, 2021 | ||
| Sudhir Kumar Nallapaneni | Adp of the SNF | Aug 1, 2022 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Adp of the SNF | Aug 31, 2015 | ||
| Kathyrn Young | Operational/Managerial Control | Aug 1, 2022 | |
| Adp of the SNF | Aug 1, 2022 | ||
| Jennifer Cox | Operational/Managerial Control | Dec 1, 2003 | |
| Adp of the SNF | Dec 1, 2003 | ||
| Deborah Smith | Operational/Managerial Control | Sep 16, 2017 | |
| Adp of the SNF | Sep 16, 2017 | ||
| Joseph White | Operational/Managerial Control | May 5, 2008 | |
| Adp of the SNF | May 5, 2008 | ||
| Adp of the SNF | Jan 1, 2004 | ||
| Adp of the SNF | Jan 1, 2012 | ||
| Adp of the SNF | Aug 31, 2015 | ||
| Hill, Barth & King LLC | Adp of the SNF | Jan 1, 2004 | |
| Mary Beth Chaffin | Operational/Managerial Control | Mar 16, 2023 | |
| Adp of the SNF | Mar 16, 2023 | ||
| Edward Reese | 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% | |
| Adp of the SNF | Apr 1, 2025 | ||
| Amanda Rivera | Operational/Managerial Control | Dec 16, 2020 | |
| Adp of the SNF | Dec 16, 2020 | ||
| Adp of the SNF | Jan 1, 2012 | ||
| Edward Reese | Operational/Managerial Control | Jul 13, 2010 | |
| Adp of the SNF | Jul 13, 2010 | ||
| Adp of the SNF | Apr 1, 2025 | ||
| Kevin Ferguson | Operational/Managerial Control | Nov 10, 2023 | |
| Adp of the SNF | Nov 10, 2023 | ||
| Farmers National Bank Canfield | 5% Or Greater Mortgage Interest | Aug 31, 2015 | 100% |
| Adp of the SNF | Aug 31, 2015 | ||
| Adp of the SNF | Jan 1, 2012 | ||
| Adp of the SNF | Jan 1, 2012 | ||
| Adp of the SNF | Jan 1, 2014 | ||
| Wem & Associates, Inc | Adp of the SNF | Jan 1, 2024 | |
| Edm Management, Inc | Operational/Managerial Control | Dec 1, 2003 | |
| Adp of the SNF | Dec 1, 2003 | ||
| Ovation Rehabilitation Services LLC | Operational/Managerial Control | Apr 1, 2025 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Diane J. Reese Family Trust I | Adp of the SNF | May 1, 2021 | |
| Direct Ownership Interest | May 1, 2021 | 50% | |
| Diane Reese | 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% | |
| Amanda Mackie | Operational/Managerial Control | Feb 16, 2023 | |
| Adp of the SNF | Feb 16, 2023 | ||
| Adp of the SNF | Jan 1, 2004 | ||
| 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.
-
- Internal Medicine Physician
- Canfield, OH
- NPI 1477553535
Adp of the SNF
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Boardman, OH
- NPI 1316530959
Edm Management, Inc, Ovation Rehabilitation Services LLC
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.
-
- Assisted Living Facility
- Austintown, OH
- NPI 1639959992
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Canfield, OH
- NPI 1477553535
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.