NPIMap

Organization Active NPI

Shepherd of the Valley Lutheran Retirement Services, Inc.

Doing business as Shepherd of the Valley Poland

  • Skilled Nursing Facility
  • Poland, OH
National Provider Identifier
1447797022
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Doing business as
Shepherd of the Valley Poland
Practice address
301 W Western Reserve Rd
Poland, OH 44514-3527
Phone
(330) 726-7110
NPI assigned
Jan 20, 2017
Last updated
Jan 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Karen Bovard
Title
President
Phone
(330) 726-7110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

301 W Western Reserve Rd
Poland, OH 44514-3527

Mailing address

301 W Western Reserve Rd
Poland, OH 44514-3527
Phone (330) 726-7110

Other names 1

  • Shepherd of the Valley Poland Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170223002432 OH Part A Provider - Skilled Nursing Facility 2961310180 Practice locations: Poland, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447797022. Details of each certification follow.

Skilled nursing facility certification: CCN 366453

Legal name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Doing business as
SHEPHERD OF THE VALLEY POLAND
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 27, 2017
Last certification
Jun 1, 2023
Beds
32
Ownership / control type
Church Related
Multi-facility organization
Shepherd Of Valley Lutheran Retirement Service Inc
Organization structure
CorporationNon-profit
Incorporated
Jan 3, 1972 in OH
Enrollment address
301 W Western Reserve Rd
Poland, OH 44514-3527
Nursing home name
SHEPHERD OF THE VALLEY POLAND

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shepherd of the Valley PolandCCN 366453 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Apr 27, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3225.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Shepherd of the Valley Lutheran Retirement Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Giuseppe B Deabate Individual Corporate OfficerPresident Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2017
Shepherd of the Valley Lutheran Retirement Services, Inc. Organization, Austintown, OH Corporation Operational/Managerial Control Jan 1, 2017
Barbara Rosenblum Individual Corporate OfficerSecretary Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2017
Kelly Stansloski Individual W-2 Managing EmployeeAssociate Director Jan 1, 2017
Diane Chermerly Tanner Individual Corporate DirectorBoard Member Jan 1, 2017
Deborah Gilbert Individual Corporate DirectorBoard Member Jan 1, 2017
Richard Limongi Individual W-2 Managing EmployeeExecutive Director Jan 1, 2017
Richard Thompson Individual Corporate OfficerTreasurer Jan 1, 2019
Corporate DirectorBoard Member Jan 1, 2017
William Leitch Individual Corporate DirectorBoard Member Jan 1, 2017
Chrisitne Filip Individual W-2 Managing EmployeeDirector of Accounting Jan 1, 2017
Adam Earnheardt Individual Corporate OfficerVice President Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2020
Victoria N Brown Individual Corporate OfficerChief Financial Officer Jan 1, 2017

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Shepherd of the Valley LibertyGirard, OH, CCN 365298 Skilled nursing facility Operational/Managerial Control Jan 1, 2017
At Home With ShepherdAustintown, OH, CCN 367741 Home health agency 5% Or Greater Indirect Ownership Interest Jan 3, 1972

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 2

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 2

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": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1447797022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143527",
            "telephone_number": "330-726-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143527",
            "telephone_number": "330-726-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "BOVARD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-726-7110"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd of the Valley Poland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.