NPIMap

Organization Active NPI

Lecom at Elmwood Gardens LLC

  • Skilled Nursing Facility
  • Erie, PA
National Provider Identifier
1073396636
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LECOM AT ELMWOOD GARDENS LLC
Practice address
2628 Elmwood Ave
Erie, PA 16508-1421
Phone
(814) 864-4802
Fax
(814) 864-7044
NPI assigned
Aug 17, 2023
Last updated
Aug 17, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLCREEK MANORAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Olivia Ware
Title
Cfo
Phone
(814) 881-5234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2628 Elmwood Ave
Erie, PA 16508-1421

Mailing address

5535 Peach St
Erie, PA 16509-2603
Phone (814) 881-5234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230821002758 PA Part A Provider - Skilled Nursing Facility 8820450927 Practice locations: Erie, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073396636. Details of each certification follow.

Skilled nursing facility certification: CCN 395474

Legal name
LECOM AT ELMWOOD GARDENS, LLC
Doing business as
LECOM SENIOR LIVING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 17, 1980
Last certification
Feb 13, 2025
Beds
51
Ownership / control type
Nonprofit Corporation
Multi-facility organization
LECOM Health
Organization structure
LLCNon-profit
Incorporated
Apr 3, 2023 in PA
Enrollment address
2628 Elmwood Ave
Erie, PA 16508-1421
Nursing home name
LECOM AT ELMWOOD GARDENS, LLC
Affiliated entity
LECOM SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lecom at Elmwood Gardens, LLCCCN 395474 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 17, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5146.7 residents per day on average
Chain
Lecom Senior Living5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Millcreek Manor Pharmacy

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
John M Ferretti Individual Corporate OfficerBoard Member Oct 1, 2023
Joshua Alan Beerbower Individual Operational/Managerial Control Nov 3, 2023
Adp of the SNF Nov 3, 2023
Millcreek Manor Organization, Erie, PA Corporation, Medical provider/supplier, Non-profit 5% Or Greater Direct Ownership Interest Apr 3, 2023 100%
Luigi G Diianni Individual Trustee of the SNF Mar 18, 2025
Silvia M Ferretti Individual Corporate OfficerBoard Member Oct 1, 2023
Joseph Kelly Individual Corporate OfficerBoard Member Oct 1, 2023
Individual Adp of the SNF Jun 28, 2024
James Yi Lin Individual Corporate DirectorMedical Director Oct 1, 2023
Trustee of the SNF Jul 1, 2024
Adp of the SNF Apr 28, 2025
Individual Adp of the SNF Apr 28, 2025
Joyce Savocchio Individual Corporate OfficerBoard Member Oct 1, 2023
Jaime Lynn Babiak Individual Operational/Managerial Control Oct 1, 2023
Adp of the SNF Oct 1, 2023
Steven Inman Individual Corporate OfficerVice President of Financial Affairs Jan 1, 2023
Esther Fucci Individual Corporate OfficerBoard Member Oct 1, 2023
Mary L Eckert Individual Corporate OfficerBoard Member Oct 1, 2023
Vincent S Fierro Individual Corporate Director Jan 1, 2023
Trustee of the SNF Jan 1, 2023

Owners & managing parties with NPI records 5

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

Facilities with the same owner 5

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

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": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1073396636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-881-5234",
            "fax_number": "814-871-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 ELMWOOD AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081421",
            "telephone_number": "814-864-4802",
            "fax_number": "814-864-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LECOM AT ELMWOOD GARDENS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLCREEK MANOR",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-881-5234"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.