Park Center Nursing LLC
Organization Active NPI Skilled Nursing Facility · Youngstown, OH
NPI 1407444359 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1407444359
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- PARK CENTER NURSING LLC
- Practice address
- 5665 South Ave
Youngstown, OH 44512-2459 - Phone
- (330) 782-1173
- NPI assigned
- Jan 6, 2021
- Organization subpart
- No
Authorized official
- Name
- Joseph Charles
- Title
- Member
- Phone
- (330) 782-1173
Owners & managing parties with NPI records 1
-
Brian W. McClain, MD
Facilities with the same owner 1
Practitioners 3
-
Brian W. McClain, MD
-
Miodrag Zivic, M.D.
Affiliated clinicians 3
-
Brian W. McClain, MD
-
Jamie Perrine, APRN-CNP
Medicare Care Compare: Nursing home
- Listed as
- Park Center Healthcare and Rehabilitation
- 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
- Apr 1, 1973
- Medicare certification status
- Active
- Certified beds
- 99 · 92.1 residents per day on average
- Chain
- David Oberlander
- Penalties (3 years)
- 1 · fines totaling $39,108
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 365185
- Legal name
- PARK CENTER NURSING LLC
- Doing business as
- PARK CENTER HEALTHCARE AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1973
- Last certification
- Apr 29, 2024
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 6, 2021 in OH
- Enrollment address
- 5665 South Avenue
Youngstown, OH 44512-2459 - Nursing home name
- PARK CENTER HEALTHCARE AND REHABILITATION
- Affiliated entity
- DAVID OBERLANDER
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Park Cernter Holdings LLC |
5% Or Greater Direct Ownership Interest | Mar 8, 2021 | 100% |
| Park Center Opco LLC |
5% Or Greater Indirect Ownership Interest | Mar 8, 2021 | 76% |
| Adp of the SNF | May 1, 2021 | ||
| Fuego LLC |
Operational/Managerial Control | May 1, 2021 | |
| David Oberlander |
5% Or Greater Direct Ownership Interest | Mar 8, 2021 | 24% |
| Operational/Managerial Control | Mar 8, 2021 | ||
| Brian McClain |
Adp of the SNF | Mar 13, 2025 | |
| Cecelia Trevino |
Adp of the SNF | Mar 5, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210318002010 | OH | Part a Provider - Skilled Nursing Facility | 7214344266 | Practice locations: Youngstown, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
5665 South Ave
Youngstown, OH 44512-2459
Mailing address
5665 South Ave
Youngstown, OH 44512-2459
Other providers in Youngstown, OH
- Neil P Parikh
- David Ralph Parilla II
- Cheyenne M Paris
- Maggie Paris
- Nicole M Parish
- Park Vista Il Ops LLC
- Park Vista SNF Ops, LLC
- Park Vista SNF Ops, LLC
- Sarah Chung Park
- Ethel Parker
All providers in Youngstown, 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 Jan 7, 2021. 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.