5000 Sowul Boulevard Opco LLC

Organization Active NPI Skilled Nursing Facility · Stow, OH

NPI 1295578243 · NPPES record last updated Jul 2, 2024

Key facts

NPI
1295578243
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
5000 SOWUL BOULEVARD OPCO LLC
Practice address
5000 Sowul Blvd
Stow, OH 44224-6092
Phone
(330) 653-8722
NPI assigned
Jun 17, 2024
Organization subpart
No

Authorized official

Name
Rachel Friedman
Title
Manager
Phone
(516) 545-0980

Facilities with the same owner 3

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Nursing home

Listed as
Hudson Springs Nursing and Rehab CCN 366434
Overall star rating
★★☆☆☆ 2 of 5
Health inspections
★★☆☆☆ 2 of 5
Staffing
★★☆☆☆ 2 of 5
Quality measures
★★★★☆ 4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 17, 2015
Medicare certification status
Active (Provider of Services file)
Certified beds
80 · 71.7 residents per day on average
Chain
Garden Springs Healthcare (5 facilities)

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2314260Hudson Springs Nursing and Rehab Laboratory
5000 Sowul Blvd, Suite 101, Stow, OH 44224
AccreditationOct 20, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Skilled nursing facility certification: CCN 366434

Legal name
5000 SOWUL BOULEVARD OPCO LLC
Doing business as
HUDSON SPRINGS NURSING AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 17, 2015
Last certification
Aug 21, 2024
Beds
80
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Garden Springs Healthcare
Organization structure
LLC · Proprietary
Incorporated
Dec 26, 2023 in OH
Enrollment address
5000 Sowul Blvd
Stow, OH 44224-6092
Nursing home name
HUDSON SPRINGS NURSING AND REHAB
Affiliated entity
GARDEN SPRINGS HEALTHCARE

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Ilya Rafi Mahilnitski
Individual
5% Or Greater Direct Ownership Interest Jun 27, 2024 35%
Corporate Officer
Vice President and Secretary
Jun 27, 2024 50%
Operational/Managerial Control Jun 27, 2024
Managing Control - Governing Body Jun 27, 2024
Adp of the SNF Jun 27, 2024
Pessi Friedman
Individual
5% Or Greater Direct Ownership Interest Jun 27, 2024 1%
Tiffany Wade
Individual
Operational/Managerial Control Jun 27, 2024
Managing Control - Governing Body
Administrator
Jun 27, 2024
Adp of the SNF Jun 27, 2024
Yfr Equities LLC
Organization · Pepper Pike, OH
LLC
5% Or Greater Direct Ownership Interest Jun 27, 2024 4%
Matis Mark Friedman
Individual
5% Or Greater Direct Ownership Interest Jun 27, 2024 46%
5% Or Greater Indirect Ownership Interest Jun 27, 2024 4.67%
Corporate Officer
Vice President and Secretary
Jun 27, 2024 50%
Corporate Director
Sole Director
Jun 27, 2024 100%
Operational/Managerial Control Jun 27, 2024
Managing Control - Governing Body
Managing Member
Jun 27, 2024
Adp of the SNF Jun 27, 2024

Organization · Stow, OH
LLC
Adp of the SNF Jan 13, 2025

Organization · Pepper Pike, OH
Direct Ownership Interest Jun 27, 2024 3%
Gitty Friedman
Individual
5% Or Greater Direct Ownership Interest Jun 27, 2024 2%

Organization · Broadview Heights, OH
Medical provider/supplier
Adp of the SNF Jan 13, 2025
Bryan Barenbaum
Individual
5% Or Greater Direct Ownership Interest
3
Jun 27, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250113001799 OH Part a Provider - Skilled Nursing Facility 9830627272 Practice locations: Stow, OH

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

5000 Sowul Blvd
Stow, OH 44224-6092

Mailing address

30100 Chagrin Blvd Ste 202
Pepper Pike, OH 44124-5722

Other providers in Stow, OH

All providers in Stow, OH · Skilled Nursing Facility in Ohio

Sources for this page

Verify at the official NPI Registry.