NPIMap

Organization Active NPI

Gardens at St. Henry Operating Company, LLC

Doing business as The Gardens at St. Henry

  • Skilled Nursing Facility
  • Saint Henry, OH
National Provider Identifier
1821614231
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GARDENS AT ST. HENRY OPERATING COMPANY, LLC
Doing business as
The Gardens at St. Henry
Practice address
522 Western Ave
Saint Henry, OH 45883-9777
Phone
(419) 678-9800
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

522 Western Ave
Saint Henry, OH 45883-9777

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2282ROtherOHLICENSURE

Other names 1

  • The Gardens at St. Henry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200902002058 OH Part A Provider - Skilled Nursing Facility 1355768532 Practice locations: Saint Henry, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821614231. Details of each certification follow.

Skilled nursing facility certification: CCN 366197

Legal name
GARDENS AT ST. HENRY OPERATING COMPANY, LLC
Doing business as
THE GARDENS AT ST. HENRY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 10, 2000
Last certification
Nov 9, 2022
Beds
25
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Lion Stone Care
Organization structure
LLCProprietary
Incorporated
Apr 27, 2020 in OH
Enrollment address
522 Western Ave
Saint Henry, OH 45883-9777
Nursing home name
GARDENS AT ST HENRY THE
Affiliated entity
LIONSTONE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Gardens at St Henry theCCN 366197 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 10, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2523.6 residents per day on average
Chain
Lionstone Care24 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Gardens at St Henry2 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
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 Jan 1, 2023
Adam Cusner Individual Corporate OfficerChief Executive Officer Jan 27, 2025
Operational/Managerial Control Jan 27, 2025
Adp of the SNF Jan 27, 2025
Individual Adp of the SNF Oct 30, 2023
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 1

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": "1592784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1821614231",
    "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": "522 WESTERN AVE",
            "city": "SAINT HENRY",
            "state": "OH",
            "postal_code": "458839777",
            "telephone_number": "419-678-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENS AT ST. HENRY 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": "2282R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Gardens at St. Henry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Gardens at St. Henry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Henry, OH

Sources for this page

Verify at the official NPI Registry.