Youngstown Area Jewish Federation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3234 Issued in OH

Legal business name

YOUNGSTOWN AREA JEWISH FEDERATION

Doing business as

Heritage Manor

Practice address

517 Gypsy LN
Youngstown, OH 44504-1314

Phone

(330) 884-6300

Fax

(330) 746-7926

NPI assigned

Jul 16, 2006

Organization subpart

Yes

Parent organization

YOUNGSTOWN AREA JEWISH FEDERATIONAs reported in NPPES

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

Authorized official

Name

David John Stauffer, CPA

Title

Cfo

Phone

(330) 397-8025

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Heritage Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Skilled nursing facility certification: CCN 365114

Legal name

YOUNGSTOWN AREA JEWISH FEDERATION

Doing business as

HERITAGE MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1967

Last certification

Nov 21, 2024

Beds

72

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 28, 1936 in OH

Enrollment address

517 Gypsy LN
Youngstown, OH 44504-1314

Nursing home name

HERITAGE MANOR JEWISH HM FOR

Other NPIs with the same Medicare PAC ID 1

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

• Youngstown Area Jewish Federation

  • Community/Behavioral Health Agency
  • Youngstown, OH
  • NPI 1841340056

  9931007713

  Same PAC ID

Listed as

Heritage Manor Jewish HM forCCN 365114 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7264.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Heritage Manor4 organizations share this tax ID, including this one

Part of

Heritage Manor

Other organizations with this tax ID 3

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

• Heritage Manor

  • Adult Day Care Clinic/Center
  • Youngstown, OH
  • NPI 1689413163
  NPD tax ID
• Levy Gardens

  • Assisted Living Facility
  • Youngstown, OH
  • NPI 1356468946
  NPD tax ID
• Youngstown Area Jewish Federation

  • Community/Behavioral Health Agency
  • Youngstown, OH
  • NPI 1841340056
  NPD tax ID

Locations

All disclosed owners & managing parties 26

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

Owners & managing parties with NPI records 1

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

• Bruce Daniel Willner, DO

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1609853076

  Adp of the SNF

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tolga Icli, MD

  • Family Medicine Physician
  • Austintown, OH
  • NPI 1114182979
  NPD (past)
• Bruce Daniel Willner, DO

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1609853076
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Tolga Icli, MD

  • Family Medicine Physician
  • Austintown, OH
  • NPI 1114182979

  Nursing home

  Care Compare affiliation
• Bruce Daniel Willner, DO

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1609853076

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1861419814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 GYPSY LN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041314",
            "telephone_number": "330-884-6300",
            "fax_number": "330-746-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 GYPSY LN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041314",
            "telephone_number": "330-884-6300",
            "fax_number": "330-746-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGSTOWN AREA JEWISH FEDERATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUNGSTOWN AREA JEWISH FEDERATION",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "STAUFFER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "330-397-8025",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "3234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0025761",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Youngs, LPN
• Jordan E Youngs
• Youngstown Academy of Excellence
• Youngstown Al-MC, LLC
• Youngstown Area Jewish Federation
• Youngstown Associates in Radiology
• Youngstown Associates in Radiology Inc
• Youngstown Behavioral Health Hospital Physician Group LLC
• Youngstown BG Opco LLC
• Youngstown Chiropractic, Inc

• Skilled Nursing Facility in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.