NPIMap

Organization Active NPI

Embassy Autumnwood Management

  • Skilled Nursing Facility
  • Rittman, OH
National Provider Identifier
1104066968
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1734N Issued in 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
Last updated
Apr 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Hayley B Williams
Title
Attorney
Phone
(216) 706-3864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1734N OH Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090602000589 OH Part A Provider - Skilled Nursing Facility 1355491986 Practice locations: Rittman, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104066968. Details of each certification follow.

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
LLCProprietary
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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Autumnwood Nursing & Rehab CenterCCN 365563 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
7552.8 residents per day on average
Chain
Embassy Healthcare33 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Embassy Autumnwood Management LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Ah Dynasty LLC Organization, Beachwood, OH LLC, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2020 50%
Heritage Employment Services, LLC Organization, Beachwood, OH LLC, Medical staffing company Operational/Managerial Control Jan 1, 2020
Sushil K Jain Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
George S. Repchick 2020 Family Dynasty Trust Organization, Shaker Heights, OH Indirect Ownership Interest Jan 1, 2020 50%
Aaron Handler Family Dynasty Trust Organization, Shaker Heights, OH Indirect Ownership Interest Jan 1, 2020 50%
Aaron B Handler Individual Operational/Managerial Control Jan 1, 2020
Adp of the SNF Jan 1, 2020
George S. Repchick Individual Operational/Managerial Control Jan 1, 2020
Amy Seiberling Individual Operational/Managerial Control Jan 1, 2020
Adp of the SNF Jan 1, 2020
Embassy Healthcare Management Inc Organization, Beachwood, OH Corporation, Management services company Operational/Managerial Control Jan 1, 2020
Adp of the SNF Apr 15, 2025
2020 GSR Dynasty LLC Organization, Beachwood, OH LLC, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2020 50%
Embassy Healthcare Holdings Inc Organization, Beachwood, OH Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%

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 36

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

View all 36

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": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1104066968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24579 BROADWAY AVE",
            "city": "OAKWOOD VILLAGE",
            "state": "OH",
            "postal_code": "441466338",
            "telephone_number": "440-658-1458",
            "fax_number": "440-232-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E SUNSET DR",
            "city": "RITTMAN",
            "state": "OH",
            "postal_code": "442701165",
            "telephone_number": "330-927-2060",
            "fax_number": "330-927-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY AUTUMNWOOD MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ATTORNEY",
        "authorized_official_telephone_number": "216-706-3864"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1734N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rittman, OH

Sources for this page

Verify at the official NPI Registry.