NPIMap

Organization Active NPI

Shepherd of the Valley Lutheran Retirement Services, Inc.

Doing business as Shepherd of the Valley - Boardman

  • Durable Medical Equipment & Medical Supplies
  • Youngstown, OH
National Provider Identifier
1093808529
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Doing business as
Shepherd of the Valley - Boardman
Practice address
7148 West Blvd.
Youngstown, OH 44512-4336
Phone
(330) 726-9061
NPI assigned
Oct 2, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Victoria N. Brown
Title
Associate Director/Cfo
Phone
(330) 530-4038

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4706 OH
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

7148 West Blvd.
Youngstown, OH 44512-4336

Mailing address

5525 Silica Road
Austintown, OH 44515-1002
Phone (330) 530-4038

Other identifiers 1

IdentifierTypeStateIssuer
0346030MedicaidOH

Other names 1

  • Shepherd of the Valley - Boardman Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507001071 OH Part A Provider - Skilled Nursing Facility 2961310180 Practice locations: Boardman, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093808529. Details of each certification follow.

Skilled nursing facility certification: CCN 365580

Legal name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Doing business as
SHEPHERD OF THE VALLEY BOARDMAN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 22, 1982
Last certification
Mar 23, 2023
Beds
57
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 3, 1972 in OH
Enrollment address
7148 West Blvd
Boardman, OH 44512-4336
Nursing home name
SHEPHERD OF THE VALLEY-BOARDMAN

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shepherd of the Valley-BoardmanCCN 365580 · All quality measures
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
Non profit - Corporation
Certified
Mar 22, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5744.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Shepherd of the Valley Lutheran Retirement Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Giuseppe B Deabate Individual Corporate OfficerPresident Jan 1, 2020
Corporate DirectorDirector Jan 1, 2019
Cory Parish Individual W-2 Managing EmployeeAssociate Director Sep 8, 2015
Robert Quaintance Individual Corporate DirectorSecretary Jan 1, 2023
Richard Limongi Individual Corporate OfficerCeo Jan 1, 2015 100%
W-2 Managing EmployeeCeo Jan 1, 1993
Richard Thompson Individual Corporate DirectorTreasurer Jan 1, 2019
Paul Adamic Individual Corporate OfficerCfo Jun 20, 2022
W-2 Managing EmployeeCfo Jun 20, 2022
Chrisitne Filip Individual W-2 Managing EmployeeAccounting Director Oct 19, 2008
Adam Earnheardt Individual Corporate OfficerVice President Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2020

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shepherd of the Valley LibertyGirard, OH, CCN 365298 Skilled nursing facility Operational/Managerial Control Jan 1, 2017
Shepherd of the Valley PolandPoland, OH, CCN 366453 Skilled nursing facility Operational/Managerial Control Jan 1, 2017
At Home With ShepherdAustintown, OH, CCN 367741 Home health agency 5% Or Greater Indirect Ownership Interest Jan 3, 1972

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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 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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093808529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 SILICA ROAD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151002",
            "telephone_number": "330-530-4038",
            "fax_number": "330-530-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 WEST BLVD.",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124336",
            "telephone_number": "330-726-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR/CFO",
        "authorized_official_telephone_number": "330-530-4038"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "4706",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0346030",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd of the Valley - Boardman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.