Public record

CMS Skilled Nursing Facility All Owners

Associate id: 3274903653 · 46 matching records

Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
0042210924
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-22
First name - owner
DANIEL
Middle name - owner
W
Last name - owner
FUNK
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
0042210924
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2022-09-22
First name - owner
DANIEL
Middle name - owner
W
Last name - owner
FUNK
Title - owner
COO
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
0042210924
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-09-22
First name - owner
DANIEL
Middle name - owner
W
Last name - owner
FUNK
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
0547743288
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2026-02-16
First name - owner
JAMES
Last name - owner
HAYWARD
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
0547743288
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-02-16
First name - owner
JAMES
Last name - owner
HAYWARD
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
2264904036
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-04-01
Address line 1 - owner
7080 SW FIR LOOP
Address line 2 - owner
STE 100
City - owner
PORTLAND
State - owner
OR
Zip code - owner
972238149
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
Y
For profit - owner
Y
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
2860428380
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-22
First name - owner
KENNETH
Middle name - owner
M
Last name - owner
FUNK
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
2860428380
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2022-09-22
First name - owner
KENNETH
Middle name - owner
M
Last name - owner
FUNK
Title - owner
CEO
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
2860428380
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-09-22
First name - owner
KENNETH
Middle name - owner
M
Last name - owner
FUNK
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
2860428380
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-22
First name - owner
KENNETH
Middle name - owner
M
Last name - owner
FUNK
Percentage ownership
100
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
3072983451
Type - owner
O
Role code - owner
85
Role text - owner
DIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-22
Organization name - owner
BLUE LAKE POST CUTE HOLDCO LLC
Address line 1 - owner
769 NE 77TH TER
City - owner
MIAMI
State - owner
FL
Zip code - owner
331385217
Percentage ownership
100
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
Y
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
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
3476046491
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-03-31
First name - owner
HOWARD
Last name - owner
LIPKOWITZ
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
3476046491
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-03-31
First name - owner
HOWARD
Last name - owner
LIPKOWITZ
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
3971096918
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-04-01
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
4486058088
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2026-02-24
First name - owner
JORGE
Middle name - owner
L
Last name - owner
MARTINEZ SALAS
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
4486058088
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-02-24
First name - owner
JORGE
Middle name - owner
L
Last name - owner
MARTINEZ SALAS
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
5193196756
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-22
Organization name - owner
KMOM LLC
Address line 1 - owner
851 NE 1ST AVE
City - owner
MIAMI
State - owner
FL
Zip code - owner
331321817
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
Y
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
5294228219
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-09-08
First name - owner
BRITTANI
Last name - owner
DANIELS
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
5294228219
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-09-08
First name - owner
BRITTANI
Last name - owner
DANIELS
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6204329220
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-05-12
First name - owner
SHEREE
Last name - owner
EASON
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6204329220
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-05-12
First name - owner
SHEREE
Last name - owner
EASON
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6406349448
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-05-12
First name - owner
ALANA
Middle name - owner
C
Last name - owner
KEMP
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6406349448
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-05-12
First name - owner
ALANA
Middle name - owner
C
Last name - owner
KEMP
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6406882711
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-03-01
First name - owner
PATRICIA
Last name - owner
ROMERO
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6406882711
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-03-01
First name - owner
PATRICIA
Last name - owner
ROMERO
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6709379746
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-09-22
Address line 1 - owner
769 NE 77TH TER
City - owner
MIAMI
State - owner
FL
Zip code - owner
331385217
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
Y
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
6800389842
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-06-26
Address line 1 - owner
7080 SW FIR LOOP
Address line 2 - owner
STE 100
City - owner
PORTLAND
State - owner
OR
Zip code - owner
972238149
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
Y
For profit - owner
Y
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7012400047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-02-12
First name - owner
JEREMIAH
Last name - owner
NEUBIA
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7012400047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-12
First name - owner
JEREMIAH
Last name - owner
NEUBIA
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7113945874
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-01-01
First name - owner
HUSAM
Middle name - owner
E
Last name - owner
EDDIN
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7113945874
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
HUSAM
Middle name - owner
E
Last name - owner
EDDIN
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7214420256
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-08-11
First name - owner
ALEXIS
Middle name - owner
E
Last name - owner
CAMPBELL
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7214420256
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-08-11
First name - owner
ALEXIS
Middle name - owner
E
Last name - owner
CAMPBELL
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7416323332
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-07-19
First name - owner
STERLING
Middle name - owner
D
Last name - owner
SMITH
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7416323332
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2024-07-19
First name - owner
STERLING
Middle name - owner
D
Last name - owner
SMITH
Title - owner
CFO
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7416323332
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-07-19
First name - owner
STERLING
Middle name - owner
D
Last name - owner
SMITH
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7517337991
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-22
Organization name - owner
ELEVATION HEALTHCARE LLC
Doing business as name - owner
ELEVATION GROUP
Address line 1 - owner
851 NE 1ST AVENUE
Address line 2 - owner
VILLA 701
City - owner
MIAMI
State - owner
FL
Zip code - owner
33132
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
Y
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
Y
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7517337991
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-06-01
Organization name - owner
ELEVATION HEALTHCARE LLC
Doing business as name - owner
ELEVATION GROUP
Address line 1 - owner
851 NE 1ST AVENUE
Address line 2 - owner
VILLA 701
City - owner
MIAMI
State - owner
FL
Zip code - owner
33132
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
Y
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
Y
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
7517337991
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-22
Organization name - owner
ELEVATION HEALTHCARE LLC
Doing business as name - owner
ELEVATION GROUP
Address line 1 - owner
851 NE 1ST AVENUE
Address line 2 - owner
VILLA 701
City - owner
MIAMI
State - owner
FL
Zip code - owner
33132
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
Y
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
Y
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
8123511169
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-07-16
First name - owner
MICHELLE
Last name - owner
KARPOWICZ
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
8123511169
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-16
First name - owner
MICHELLE
Last name - owner
KARPOWICZ
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
8426541467
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-22
Address line 1 - owner
420 S ORANGE AVE
Address line 2 - owner
STE 900
City - owner
ORLANDO
State - owner
FL
Zip code - owner
328014901
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
Y
For profit - owner
Y
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
Y
Other type text - owner
LIMITED LIABILITY PARTNERSHIP
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
8820440126
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-07-01
First name - owner
JACOB
Last name - owner
LINDSEY
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
8820440126
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2025-07-01
First name - owner
JACOB
Last name - owner
LINDSEY
Title - owner
DIRECTOR OF OPERATIONS
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
8820440126
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-01
First name - owner
JACOB
Last name - owner
LINDSEY
Enrollment id
O20221229000261
Associate id
3274903653
Organization name
BLUE LAKE POST ACUTE LLC
Associate id - owner
9335632371
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-22
Doing business as name - owner
PHARMERICA
Address line 1 - owner
337 NORTHLAKE BLVD
City - owner
ALTAMONTE SPRINGS
State - owner
FL
Zip code - owner
327015264
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
Y
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
Trust or trustee - owner
N
Other type - owner
N

This record is displayed as returned by the government data source. Open the raw file · About this dataset · Full source list