Laurel Lake Retirement Community, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4131 Issued in OH

Legal business name

LAUREL LAKE RETIREMENT COMMUNITY, INC.

Practice address

200 Laurel Lake Dr
Hudson, OH 44236-2156

Phone

(330) 655-1402

Fax

(330) 655-1700

NPI assigned

Aug 27, 2005

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie Covas

Title

Administrator

Phone

(330) 655-1402

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295728905. Details of each certification follow.

• CCN 365793 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 365793

Legal name

LAUREL LAKE RETIREMENT COMMUNITY, INC.

Doing business as

CROWN CENTER AT LAUREL LAKE

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

May 4, 1990

Last certification

Aug 17, 2023

Beds

75

Ownership / control type

Other Nonprofit

Organization structure

CorporationNon-profit

Incorporated

May 10, 1985 in OH

Enrollment address

200 Laurel Lake Dr
Hudson, OH 44236

Nursing home name

CROWN CENTER AT LAUREL LAKE

Listed as

Crown Center at Laurel LakeCCN 365793 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare

Ownership

Non profit - Corporation

Certified

May 4, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7561.1 residents per day on average

Penalties (3 years)

20Fines totaling $111,970

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Northeast Ohio Home Care

  dba Eliza at Home

  • Home Health Agency
  • Olmsted TWP, OH
  • NPI 1467655944

  Member Of

  NPD member
• Northeast Ohio Hospice, Inc.

  • Community Based Hospice Care Agency
  • Garfield Heights, OH
  • NPI 1386178341

  Member Of

  NPD member

All disclosed owners & managing parties 7

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

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 2

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

• Northeast Ohio Home Care

  dba Eliza at Home

  • Home Health Agency
  • Olmsted TWP, OH
  • NPI 1467655944

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Northeast Ohio Hospice, Inc.

  • Community Based Hospice Care Agency
  • Garfield Heights, OH
  • NPI 1386178341

  5% Or Greater Direct Ownership Interest

  CMS ownership

Affiliated clinicians 3

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

• Shelby Joseph Cash III, MD

  • Internal Medicine Physician
  • Hudson, OH
  • NPI 1851384036

  Nursing home

  Care Compare affiliation
• Joseph Matthew Chase, M.D.

  • Family Medicine Physician
  • Stow, OH
  • NPI 1508858358

  Nursing home

  Care Compare affiliation
• Paul Gibbons, M.D.

  • Internal Medicine Physician
  • Stow, OH
  • NPI 1073591426

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1295728905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAUREL LAKE DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362156",
            "telephone_number": "330-655-1402",
            "fax_number": "330-655-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAUREL LAKE DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362156",
            "telephone_number": "330-655-1402",
            "fax_number": "330-655-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL LAKE RETIREMENT COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "COVAS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "330-655-1402",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "4131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hank Lamm, LPCC
• Julie A Lang
• Troy Lang, PT, DPT
• Mae Larivee, PT
• Janine Marie Laughlin, P.T.
• Jason Lawrence, D.D.S., M.S.
• Tempa Michelle Lawrence
• Wayne Alan Lawrence, DPM
• Mary Lawson
• Bryan M Lazzara, M.D.

• Skilled Nursing Facility in Hudson, OH
• Providers in Hudson, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.