Public record

CMS Rural Health Clinic All Owners

Associate id: 1850761685 · 18 matching records

Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
0042724411
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2025-07-01
First name - owner
TINA
Middle name - owner
SSN
Last name - owner
MAY
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
1153712328
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2021-07-01
First name - owner
MICHELLE
Last name - owner
JOHNSON
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
1254501588
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2011-07-01
First name - owner
THOMAS
Last name - owner
KNOBLACH
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
1456609700
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2019-09-30
First name - owner
MICHAEL
Middle name - owner
A
Last name - owner
BLAIR
Title - owner
CEO/SR. VP
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
1456609700
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2019-09-30
First name - owner
MICHAEL
Middle name - owner
A
Last name - owner
BLAIR
Title - owner
CEO/SR. VP
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
1658645502
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-07-01
First name - owner
JEFFREY
Last name - owner
GAU
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
2264621580
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-07-01
First name - owner
RENEE
Middle name - owner
S
Last name - owner
FRAUENDIENST
Title - owner
BOARD MEMBER
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
2264710318
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2024-07-01
First name - owner
JACOB
Last name - owner
LYONS
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
3476745274
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-04-21
First name - owner
RICHARD
Last name - owner
WEHSELER
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
3678766177
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-01
First name - owner
BOBBIE
Last name - owner
BERTRAM
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
4082524566
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-06-30
First name - owner
KENNETH
Middle name - owner
D
Last name - owner
HOLMEN
Title - owner
CEO/BOARD MEMBER
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
4183955727
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2019-09-30
First name - owner
SHERRI
Last name - owner
LIEBL
Title - owner
DIRECTOR OF REVENUE
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
6305044769
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-04-21
First name - owner
DAVID
Last name - owner
ANFINSON
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
7416493507
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-07-01
First name - owner
DANIEL
Last name - owner
ABDUL
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
7618010315
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-07-01
First name - owner
JAMES
Last name - owner
HEBL
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
8325584410
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-07-01
First name - owner
CARRIE
Last name - owner
HENNING-SMITH
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
8729990833
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
Organization name - owner
CENTRACARE HEALTH SYSTEM
Doing business as name - owner
CENTRACARE EMERGENCY MEDICAL SERVICES
Address line 1 - owner
1406 6TH AVE N
City - owner
SAINT CLOUD
State - owner
MN
Zip code - owner
563031900
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
Y
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20230112000151
Associate id
1850761685
Organization name
CENTRACARE HEALTH - BENSON LLC
Associate id - owner
9436185766
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-07-01
First name - owner
BRYAN
Last name - owner
ROLPH

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