Embassy Longmeadow LLC
Organization Active NPI Skilled Nursing Facility · Ravenna, OH
NPI 1912374083 · NPPES record last updated Sep 29, 2015
Key facts
- NPI
- 1912374083
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1628N (OH)
- Legal business name
- EMBASSY LONGMEADOW LLC
- Practice address
- 565 Bryn Mawr St
Ravenna, OH 44266-9696 - Phone
- (330) 297-5781
- Fax
- (330) 297-6921
- NPI assigned
- Aug 25, 2015
- Organization subpart
- No
Authorized official
- Name
- Hayley B Williams
- Title
- Attorney
- Phone
- (216) 706-3936
Facilities with the same owner 29
Practitioners 3
-
David Thomas Hughes, M.D.
-
John P Wagner, DO
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Longmeadow Care Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 22, 1978
- Medicare certification status
- Active
- Certified beds
- 99 · 56.3 residents per day on average
- Chain
- Embassy Healthcare
- Penalties (3 years)
- 2 · fines totaling $47,486
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0946911 | Embassy Longmeadow LLC | Certificate of waiver | Jun 3, 2028 |
| 36D2337668 | Longmeadow Care Center | Certificate of waiver | Jan 26, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 365354
- Legal name
- EMBASSY LONGMEADOW LLC
- Doing business as
- LONGMEADOW CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 22, 1978
- Last certification
- Apr 1, 2025
- Beds
- 99
- Ownership / control type
- Corporation
- Most recent change of ownership
- Sep 1, 2015
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 1, 2014 in OH
- Enrollment address
- 565 Bryn Mawr St
Ravenna, OH 44266-9696 - Nursing home name
- LONGMEADOW CARE CENTER
- Affiliated entity
- EMBASSY HEALTHCARE
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Christian Health Network II LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2014 | 30% |
| Jill D Hoffman |
W-2 Managing Employee |
Feb 1, 2015 | 100% |
| Aaron B Handler |
5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 70% |
| Corporate Officer |
Sep 1, 2015 | 100% | |
| Corporate Director |
Sep 1, 2015 | 100% | |
| Embassy Healthcare Holdings Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2020 | 70% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160505000107 | OH | Part a Provider - Skilled Nursing Facility | 2567761059 | Practice locations: Ravenna, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1628N | OH | Yes |
Addresses
Primary practice location
565 Bryn Mawr St
Ravenna, OH 44266-9696
Mailing address
24579 Broadway Ave
Oakwood Village, OH 44146-6338
Phone (330) 297-5781
Other names
- Longmeadow Care Center
Other providers in Ravenna, OH
- Caitlin Elgin
- Elite Pharmacy Ravenna LLC
- Tear Daviana Ellington
- Paige Ellis
- Catherine Ellison
- Emeritus Corporation
- Sondra Emmerling
- Daniel Ensinger
- Eric J Paul
- Tayler Errera
All providers in Ravenna, OH · Skilled Nursing Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.