Gustavus Senior Care

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

Legal business name

GUSTAVUS SENIOR CARE

Practice address

8785 Youngstown Kingsville Rd
Farmdale, OH 44417-9803

Phone

(330) 355-7000

NPI assigned

Sep 15, 2025

Organization subpart

No

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

Authorized official

Name

Robert Leslie Miller

Title

Chairman of Board

Phone

(330) 876-6573

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1992676993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8785 YOUNGSTOWN KINGSVILLE RD",
            "city": "FARMDALE",
            "state": "OH",
            "postal_code": "444179803",
            "telephone_number": "330-355-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8785 YOUNGSTOWN KINGSVILLE RD",
            "city": "FARMDALE",
            "state": "OH",
            "postal_code": "444179803",
            "telephone_number": "330-355-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVUS SENIOR CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "CHAIRMAN OF BOARD",
        "authorized_official_telephone_number": "330-876-6573"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Jo Davison, RDN, LDN
• Brooke Lynn Eucker, FNP
• Meghan Hiland, MSSA, LISW
• Johnston Township Trustees
• Peggy Ann Tenney, LPN
• Liza Yoder

• All providers in Farmdale, OH
• Nursing Home Administrator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.