Embassy Autumnwood Management
Organization Active NPI Skilled Nursing Facility · Rittman, OH
NPI 1104066968 · NPPES record last updated Apr 24, 2014
Key facts
- NPI
- 1104066968
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1734N (OH)
- Legal business name
- EMBASSY AUTUMNWOOD MANAGEMENT
- Practice address
- 275 E Sunset Dr
Rittman, OH 44270-1165 - Phone
- (330) 927-2060
- Fax
- (330) 927-4501
- NPI assigned
- Mar 5, 2009
- Organization subpart
- No
Authorized official
- Name
- Hayley B Williams
- Title
- Attorney
- Phone
- (216) 706-3864
Owners & managing parties with NPI records 1
Corporate family (same tax ID) 2
Facilities with the same owner 36
Practitioners 1
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Autumnwood Nursing & Rehab Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 19, 1981
- Medicare certification status
- Active
- Certified beds
- 75 · 52.8 residents per day on average
- Chain
- Embassy Healthcare
- Penalties (3 years)
- 1 · fines totaling $0
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 365563
- Legal name
- EMBASSY AUTUMNWOOD MANAGEMENT
- Doing business as
- AUTUMNWOOD NURSING AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 19, 1981
- Last certification
- May 27, 2025
- Beds
- 75
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Embassy Healthcare
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 25, 2008 in OH
- Enrollment address
- 275E Sunset Dr
Rittman, OH 44270-1165 - Nursing home name
- AUTUMNWOOD NURSING & REHAB CENTER
- Affiliated entity
- EMBASSY HEALTHCARE
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Ah Dynasty LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Heritage Employment Services, LLC |
Operational/Managerial Control | Jan 1, 2020 | |
| Sushil K Jain |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| George S. Repchick 2020 Family Dynasty Trust |
Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Aaron Handler Family Dynasty Trust |
Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Aaron B Handler |
Operational/Managerial Control | Jan 1, 2020 | |
| Adp of the SNF | Jan 1, 2020 | ||
| George S. Repchick |
Operational/Managerial Control | Jan 1, 2020 | |
| Amy Seiberling |
Operational/Managerial Control | Jan 1, 2020 | |
| Adp of the SNF | Jan 1, 2020 | ||
| Embassy Healthcare Management Inc |
Operational/Managerial Control | Jan 1, 2020 | |
| Adp of the SNF | Apr 15, 2025 | ||
| 2020 GSR Dynasty LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Embassy Healthcare Holdings Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2020 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090602000589 | OH | Part a Provider - Skilled Nursing Facility | 1355491986 | Practice locations: Rittman, OH |
National Provider Directory
- Tax ID family
- Embassy Autumnwood Management
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1734N | OH | Yes |
Addresses
Primary practice location
275 E Sunset Dr
Rittman, OH 44270-1165
Mailing address
24579 Broadway Ave
Oakwood Village, OH 44146-6338
Phone (440) 658-1458
Other providers in Rittman, OH
- Curtis D. Ferriman O.D.
- James Darnell
- Pamela Sue Davis
- Margory Ann Dheel
- Kristen Diane Eash
- Embassy Autumnwood Management
- Embassy Autumnwood Management, LLC
- Elizabeth Marie Fisher
- Paul Ernest Fracasso
- Dawn Christine French
All providers in Rittman, OH · Skilled Nursing Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.