Glendora Divine Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GLENDORA DIVINE OPCO LLC

Practice address

1552 N Honeytown Rd
Wooster, OH 44691-9511

Phone

(330) 620-7828

NPI assigned

Apr 30, 2025

Organization subpart

No

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

Authorized official

Name

Jeffrey Degyanksy

Title

VP of Operations

Phone

(330) 620-7828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1942098744",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 N HONEYTOWN RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919511",
            "telephone_number": "330-620-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDORA DIVINE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "DEGYANKSY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "330-620-7828"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Gifford, BSW, LSW
• Jessica M Gillman
• Emily Mariah Gilmore, SLP
• Angela Jo Giltner, LSW, LCOC III
• Sylvester Ginn
• Victoria L Glorioso, LISW
• Deayera D Glover
• Carlos Goad
• Cydney Anne Godman, DO
• Lisa Ashley Goins, MSSA, LISW

• Skilled Nursing Facility in Wooster, OH
• Providers in Wooster, 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 Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.