NPIMap

Organization Active NPI

Heatherdowns Operating Company LLC

Doing business as Heatherdowns Rehad & Residential Care Center

  • Skilled Nursing Facility
  • Toledo, OH
National Provider Identifier
1568088995
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HEATHERDOWNS OPERATING COMPANY LLC
Doing business as
Heatherdowns Rehad & Residential Care Center
Practice address
2401 Cass Rd
Toledo, OH 43614-3119
Phone
(419) 382-5050
NPI assigned
Jun 22, 2020
Last updated
Dec 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Mr. Jeffrey Degyansky, LNHA
Title
Vice President of Operations
Phone
(330) 620-7828

Specialties & licenses 1

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

Addresses

Primary practice location

2401 Cass Rd
Toledo, OH 43614-3119

Mailing address

5915 Landerbrook Dr Ste 350
Mayfield Heights, OH 44124-4063
Phone (330) 620-7828

Other identifiers 1

IdentifierTypeStateIssuer
1912NOtherOHLICENSURE

Other names 1

  • Heatherdowns Rehad & Residential Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200829000009 OH Part A Provider - Skilled Nursing Facility 2062839582 Practice locations: Toledo, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568088995. Details of each certification follow.

Skilled nursing facility certification: CCN 365737

Legal name
HEATHERDOWNS OPERATING COMPANY LLC
Doing business as
HEATHERDOWNS NURSING AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 15, 1989
Last certification
Feb 10, 2025
Beds
84
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Lionstone Care Management
Organization structure
LLCProprietary
Incorporated
Apr 27, 2020 in OH
Enrollment address
2401 Cass Rd
Toledo, OH 43614-3119
Nursing home name
HEATHERDOWNS REHAB & RESIDENTIAL CARE CENTER
Affiliated entity
LIONSTONE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heatherdowns Rehab & Residential Care CenterCCN 365737 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 15, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8477.1 residents per day on average
Chain
Lionstone Care24 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0861288Heatherdowns Nursing and Rehab2401 Cass Road, Toledo, OH 43614Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Heatherdowns Operating Company LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Solomon Kazarnovsky Individual 5% Or Greater Indirect Ownership InterestManaging Partner Jan 1, 2023 50%
Corporate OfficerManaging Partner Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Individual Adp of the SNF Jul 31, 2023
Eliezer Goldish Individual Corporate OfficerChief Financial Officer Oct 9, 2023
Operational/Managerial Control Oct 9, 2023
Adp of the SNF Oct 9, 2023
Individual Adp of the SNF Mar 17, 2023
Adam Cusner Individual Corporate OfficerChief Executive Officer Jan 27, 2025
Operational/Managerial Control Jan 27, 2025
Adp of the SNF Jan 27, 2025
Jeffrey Degyansky Individual Corporate OfficerChief Operating Officer Jan 1, 2020
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Lionstone HZ Opco Holdings LLC Organization, Valley Stream, NY LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2023 100%
Abba Stein Individual 5% Or Greater Indirect Ownership InterestManaging Partner Jan 1, 2023 50%
Corporate OfficerManaging Partner Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 3

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 3

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": "1592784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1568088995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5915 LANDERBROOK DR STE 350",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441244063",
            "telephone_number": "330-620-7828",
            "fax_number": "216-428-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CASS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143119",
            "telephone_number": "419-382-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHERDOWNS OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "DEGYANSKY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "330-620-7828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "1912N",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heatherdowns Rehad & Residential Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heatherdowns Rehad & Residential Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.