Public record

CMS Home Health Agency All Owners

Associate id: 5092885376 · 29 matching records

Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
0042380339
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2020-12-31
First name - owner
CHRISTOPHER
Last name - owner
MELLEY
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
0042380339
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2008-03-17
First name - owner
CHRISTOPHER
Last name - owner
MELLEY
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
0840736492
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2023-05-17
First name - owner
AMANDA
Last name - owner
ATTIA
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
2264880160
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
BB-HH HOLDINGS, LLC
Address line 1 - owner
515 MADISON AVE
Address line 2 - owner
RM 14C
City - owner
NEW YORK
State - owner
NY
Zip code - owner
100225493
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
3173971074
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
BLACKBERN HH INVESTMENTS, LLC
Address line 1 - owner
515 MADISON AVE
Address line 2 - owner
RM 14C
City - owner
NEW YORK
State - owner
NY
Zip code - owner
100225493
Percentage ownership
51.94
Created for acquisition - owner
Y
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
4082000799
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
THE CHRISTOPHER MELLEY IRREVOCABLE TRUST DATED OCTOBER 30, 2020
Address line 1 - owner
5292 SUMMERLIN COMMONS WAY
Address line 2 - owner
STE 1102
City - owner
FORT MYERS
State - owner
FL
Zip code - owner
339072163
Percentage ownership
47.95
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
5193633667
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
MATEVOSYAN INC
Doing business as name - owner
DEDICATED NURSING ASSOCIATES
Address line 1 - owner
80 RUE LOU HEMMER
City - owner
SENNINGERBER
Percentage ownership
30.54
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
SPECIAL LIMITED PARTNERSHIP
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
5991153892
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
MELLEY HOME HEALTH HOLDINGS, LLC
Address line 1 - owner
2826 TIBURON BLVD E
Address line 2 - owner
APT 101
City - owner
NAPLES
State - owner
FL
Zip code - owner
341093663
Percentage ownership
47.95
Created for acquisition - owner
Y
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
6800244708
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
P3-PE, LLC
Address line 1 - owner
601 UNION ST
Address line 2 - owner
STE 3920
City - owner
SEATTLE
State - owner
WA
Zip code - owner
981014054
Percentage ownership
11.48
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
6901292614
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
PROVIDIA HOME CARE HOLDINGS LLC
Address line 1 - owner
5292 SUMMERLIN COMMONS WAY
Address line 2 - owner
STE 1102
City - owner
FORT MYERS
State - owner
FL
Zip code - owner
339072163
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
6901292614
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-05-16
Organization name - owner
PROVIDIA HOME CARE HOLDINGS LLC
Address line 1 - owner
5292 SUMMERLIN COMMONS WAY
Address line 2 - owner
STE 1102
City - owner
FORT MYERS
State - owner
FL
Zip code - owner
339072163
Percentage ownership
100
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
7719335512
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
BB-HH PLATFORM, INC.
Address line 1 - owner
251 LITTLE FALLS DR
City - owner
WILMINGTON
State - owner
DE
Zip code - owner
198081674
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
9234513037
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2022-07-14
First name - owner
AMY
Last name - owner
MONTGOMERY
Title - owner
DIRECTOR OF NURSING
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
9537517339
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-05-31
First name - owner
CHRISTOPH
Last name - owner
PETERS
Enrollment id
O20080529000163
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
9537517339
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2023-05-31
First name - owner
CHRISTOPH
Last name - owner
PETERS
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
0042380339
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-05-16
First name - owner
CHRISTOPHER
Last name - owner
MELLEY
Title - owner
CHIEF EXECUTIVE OFFICER (CEO)
Percentage ownership
50
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
0042380339
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2023-05-16
First name - owner
CHRISTOPHER
Last name - owner
MELLEY
Title - owner
CHIEF EXECUTIVE OFFICER (CEO)
Percentage ownership
50
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
2264880160
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
BB-HH HOLDINGS, LLC
Address line 1 - owner
515 MADISON AVE
Address line 2 - owner
RM 14C
City - owner
NEW YORK
State - owner
NY
Zip code - owner
100225493
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
3173971074
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
BLACKBERN HH INVESTMENTS, LLC
Address line 1 - owner
515 MADISON AVE
Address line 2 - owner
RM 14C
City - owner
NEW YORK
State - owner
NY
Zip code - owner
100225493
Percentage ownership
51.94
Created for acquisition - owner
Y
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
3678099355
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2024-10-04
First name - owner
TARA
Middle name - owner
KIMBERLY
Last name - owner
SCHMIDT
Title - owner
CLINICAL MANAGER
Percentage ownership
25
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
4082000799
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
THE CHRISTOPHER MELLEY IRREVOCABLE TRUST DATED OCTOBER 30, 2020
Address line 1 - owner
1447 GALLEON DR
City - owner
NAPLES
State - owner
FL
Zip code - owner
341027713
Percentage ownership
47.95
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
5193633667
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
MATEVOSYAN INC
Doing business as name - owner
DEDICATED NURSING ASSOCIATES
Address line 1 - owner
80 RUE LOU HEMMER
City - owner
SENNINGERBERG
Percentage ownership
30.54
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
SPECIAL LIMITED PARTNERSHIP
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
5991153892
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
MELLEY HOME HEALTH HOLDINGS, LLC
Address line 1 - owner
1447 GALLEON DR
City - owner
NAPLES
State - owner
FL
Zip code - owner
341027713
Percentage ownership
47.95
Created for acquisition - owner
Y
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
6800244708
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
P3-PE, LLC
Address line 1 - owner
601 UNION ST
Address line 2 - owner
STE 3920
City - owner
SEATTLE
State - owner
WA
Zip code - owner
981014054
Percentage ownership
11.48
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
6901292614
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
PROVIDIA HOME CARE HOLDINGS LLC
Address line 1 - owner
5292 SUMMERLIN COMMONS WAY
Address line 2 - owner
STE 1102
City - owner
FORT MYERS
State - owner
FL
Zip code - owner
339072163
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
6901292614
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-05-16
Organization name - owner
PROVIDIA HOME CARE HOLDINGS LLC
Address line 1 - owner
5292 SUMMERLIN COMMONS WAY
Address line 2 - owner
STE 1102
City - owner
FORT MYERS
State - owner
FL
Zip code - owner
339072163
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
7719335512
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-05-16
Organization name - owner
BB-HH PLATFORM, INC.
Address line 1 - owner
251 LITTLE FALLS DR
City - owner
WILMINGTON
State - owner
DE
Zip code - owner
198081674
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
9537517339
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-05-31
First name - owner
CHRISTOPH
Last name - owner
PETERS
Title - owner
CHIEF FINANCIAL OFFICER (CFO)
Percentage ownership
25
Enrollment id
O20250424003844
Associate id
5092885376
Organization name
PROVIDIA HOME CARE LLC
Associate id - owner
9537517339
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2023-05-31
First name - owner
CHRISTOPH
Last name - owner
PETERS
Title - owner
CHIEF FINANCIAL OFFICER (CFO)
Percentage ownership
25

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