Public record

CMS Skilled Nursing Facility All Owners

Associate id: 3971695503 · 7 matching records

Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
3173988409
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-03-01
First name - owner
ANDREW
Middle name - owner
T
Last name - owner
MONTGOMERY
Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
3173988409
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-03-01
First name - owner
ANDREW
Middle name - owner
T
Last name - owner
MONTGOMERY
Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
3274912969
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-14
First name - owner
JOSEPH
Last name - owner
STEPHENS
Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
3274998505
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2017-01-01
Organization name - owner
TILLMAN SENIOR CARE, LLC
Address line 1 - owner
321 MAIN ST
City - owner
NATCHEZ
State - owner
MS
Zip code - owner
391203461
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
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
Y
Owned by another org or ind - owner
Y
Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
5698664019
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-10-08
First name - owner
TIMOTHY
Middle name - owner
DUNCAN
Last name - owner
ESTES
Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
9830084060
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2017-01-01
First name - owner
CLIFFORD
Last name - owner
TILLMAN
Title - owner
MEMBER
Percentage ownership
99
Enrollment id
O20070827000692
Associate id
3971695503
Organization name
MAGNOLIA SENIOR CARE LLC
Associate id - owner
9830084060
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-01-01
First name - owner
CLIFFORD
Last name - owner
TILLMAN

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