NPIMap

Organization Active NPI

Embassy Park Avenue, LLC

Doing business as Embassy of Park Avenue

  • Skilled Nursing Facility
  • Meadville, PA
National Provider Identifier
1760099311
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EMBASSY PARK AVENUE, LLC
Doing business as
Embassy of Park Avenue
Practice address
14714 Park Avenue Ext
Meadville, PA 16335-9400
Phone
(814) 337-4228
NPI assigned
Sep 28, 2020
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
George Repchick
Title
President of Manager
Phone
(216) 378-2050

Specialties & licenses 1

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

Addresses

Primary practice location

14714 Park Avenue Ext
Meadville, PA 16335-9400

Mailing address

25201 Chagrin Blvd
Beachwood, OH 44122-5600

Other names 1

  • Embassy of Park Avenue Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201223000197 PA Part A Provider - Skilled Nursing Facility 6608288204 Practice locations: Meadville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760099311. Details of each certification follow.

Skilled nursing facility certification: CCN 395588

Legal name
EMBASSY PARK AVENUE, LLC
Doing business as
EMBASSY OF PARK AVENUE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1983
Last certification
Nov 22, 2024
Beds
173
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Embassy Healthcare
Organization structure
LLCProprietary
Incorporated
Aug 6, 2020 in PA
Enrollment address
14714 Park Avenue Ext
Meadville, PA 16335-9400
Nursing home name
EMBASSY OF PARK AVENUE
Affiliated entity
EMBASSY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Embassy of Park AvenueCCN 395588 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
173108.3 residents per day on average
Chain
Embassy Healthcare33 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
39D0709284Embassy of Park Avenue14714 Park Avenue Ext, Meadville, PA 16335Certificate of waiverJul 8, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Ah Dynasty LLC Organization, Beachwood, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 9, 2022 50%
Sara King Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Heritage Employment Services, LLC Organization, Beachwood, OH LLC, Medical staffing company Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jul 8, 2025
Charles E Rohrbach Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
George S. Repchick 2020 Family Dynasty Trust Organization, Shaker Heights, OH 5% Or Greater Indirect Ownership Interest Nov 9, 2022 50%
Aaron Handler Family Dynasty Trust Organization, Shaker Heights, OH 5% Or Greater Indirect Ownership Interest Nov 9, 2022 50%
Aaron B Handler Individual Corporate OfficerVice President and Secretary Nov 9, 2022 50%
Operational/Managerial Control Nov 9, 2022
Adp of the SNF Nov 9, 2022
Embassy PA Tenant 2 Holdings LLC Organization, Beachwood, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 10, 2020 100%
Embassy Healthcare Management Inc Organization, Beachwood, OH Corporation, Management services company Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jul 8, 2025
2020 GSR Dynasty LLC Organization, Beachwood, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 9, 2022 50%
Embassy Healthcare Holdings Inc Organization, Beachwood, OH Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 10, 2020 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 36

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

  • Delaware Valley Skilled Nursing Operating Company, LLC

    dba Delaware Valley Skilled Nursing & Rehabilitation Center

    • Skilled Nursing Facility
    • Matamoras, PA
    • NPI 1043809577

    2020 GSR Dynasty LLC, George S. Repchick 2020 Family Dynasty Trust

    CMS ownership
  • Embassy Hearthside, LLC

    dba Embassy of Hearthside

    • Skilled Nursing Facility
    • State College, PA
    • NPI 1467069005

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, Embassy PA Tenant 2 Holdings LLC, George S. Repchick 2020 Family Dynasty Trust, Heritage Employment Servic

    CMS ownership
  • Embassy Hermitage, LLC

    dba Hermitage Nursing and Rehabilitation

    • Skilled Nursing Facility
    • Hermitage, PA
    • NPI 1124648878

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, George S. Repchick 2020 Family Dynasty Trust, Heritage Employment Services, LLC

    CMS ownership
  • Embassy Hillsdale Park, LLC

    dba Embassy of Hillsdale Park

    • Skilled Nursing Facility
    • Hillsdale, PA
    • NPI 1831796036

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, Embassy PA Tenant 2 Holdings LLC, George S. Repchick 2020 Family Dynasty Trust, Heritage Employment Servic

    CMS ownership
  • Embassy Huntingdon Park, LLC

    dba Embassy of Huntingdon Park

    • Skilled Nursing Facility
    • Huntingdon, PA
    • NPI 1629685276

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, Embassy PA Tenant 2 Holdings LLC, George S. Repchick 2020 Family Dynasty Trust, Heritage Employment Servic

    CMS ownership
  • Embassy of East Mountain LLC

    dba Embassy of East Mountain

    • Skilled Nursing Facility
    • Wilkes Barre, PA
    • NPI 1407608128

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, George S. Repchick 2020 Family Dynasty Trust

    CMS ownership
  • Embassy of Scranton LLC

    dba Embassy of Scranton

    • Skilled Nursing Facility
    • Scranton, PA
    • NPI 1932951654

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, George S. Repchick 2020 Family Dynasty Trust

    CMS ownership
  • Embassy of Tunkhannock LLC

    dba Embassy of Tunkhannock

    • Skilled Nursing Facility
    • Tunkhannock, PA
    • NPI 1780436410

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, George S. Repchick 2020 Family Dynasty Trust

    CMS ownership
  • Embassy of Wyoming Valley LLC

    dba Embassy of Wyoming Valley

    • Skilled Nursing Facility
    • Wilkes Barre, PA
    • NPI 1730931478

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, George S. Repchick 2020 Family Dynasty Trust

    CMS ownership
  • Embassy Saxonburg LLC

    dba Embassy of Saxonburg

    • Skilled Nursing Facility
    • Saxonburg, PA
    • NPI 1205596061

    2020 GSR Dynasty LLC, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, Heritage Employment Services, LLC

    CMS ownership
  • Embassy Sharon, LLC

    dba Clepper Manor

    • Skilled Nursing Facility
    • Sharon, PA
    • NPI 1205456704

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, George S. Repchick 2020 Family Dynasty Trust, Heritage Employment Services, LLC

    CMS ownership
  • Embassy Woodland Park, LLC

    dba Embassy of Woodland Park

    • Skilled Nursing Facility
    • Orbisonia, PA
    • NPI 1982211538

    2020 GSR Dynasty LLC, Aaron Handler Family Dynasty Trust, Ah Dynasty LLC, Embassy Healthcare Holdings Inc, Embassy Healthcare Management Inc, Embassy PA Tenant 2 Holdings LLC, George S. Repchick 2020 Family Dynasty Trust, Heritage Employment Servic

    CMS ownership
View all 36

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 1

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": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1760099311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25201 CHAGRIN BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14714 PARK AVENUE EXT",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163359400",
            "telephone_number": "814-337-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY PARK AVENUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "REPCHICK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT OF MANAGER",
        "authorized_official_telephone_number": "216-378-2050"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embassy of Park Avenue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.