Public record

CMS Skilled Nursing Facility All Owners

Associate id: 4284692096 · 26 matching records

Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
0547203994
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2021-10-25
First name - owner
ROBERT
Middle name - owner
M
Last name - owner
BONNER
Title - owner
TREASURER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
0547203994
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2021-10-25
First name - owner
ROBERT
Middle name - owner
M
Last name - owner
BONNER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
0648183251
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-06-01
First name - owner
MELODY
Middle name - owner
L
Last name - owner
GABRIEL
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
1951525062
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-12-16
First name - owner
KERRY
Middle name - owner
L
Last name - owner
HEINRICH
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
1951610161
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-09-15
First name - owner
VELINO
Middle name - owner
A
Last name - owner
SALAZAR
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
2163529421
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-01-16
First name - owner
JAMES
Middle name - owner
E
Last name - owner
PEDERSEN
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
2466360177
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2014-03-31
First name - owner
MEREDITH
Middle name - owner
S
Last name - owner
JOBE
Title - owner
SECRETARY
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
3072694793
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2007-12-17
First name - owner
RICARDO
Middle name - owner
B
Last name - owner
GRAHAM
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
3971839747
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2018-07-02
First name - owner
ALICE
Middle name - owner
H
Last name - owner
ISSAI
Title - owner
PRESIDENT
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
3971839747
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2018-07-02
First name - owner
ALICE
Middle name - owner
H
Last name - owner
ISSAI
Title - owner
PRESIDENT
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
4284543125
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-01-16
First name - owner
RICHARD
Middle name - owner
K
Last name - owner
REINER
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
5496022006
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-05-05
First name - owner
ANDREW
Middle name - owner
R
Last name - owner
DAVIS
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
5496921157
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2014-03-31
First name - owner
BILLY
Middle name - owner
D
Last name - owner
WING
Title - owner
VICE CHAIR/ASSISTANT SECRETARY
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
5496921157
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-03-31
First name - owner
BILLY
Middle name - owner
D
Last name - owner
WING
Title - owner
VICE CHAIR/ASSISTANT SECRETARY
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
6002724721
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1998-09-14
First name - owner
WESLEY
Middle name - owner
E
Last name - owner
RIPPEY
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
6406000231
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-05-05
First name - owner
DAVID
Middle name - owner
P
Last name - owner
BANKS
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
7113206616
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-09-26
First name - owner
JOHN
Middle name - owner
C
Last name - owner
FREEDMAN
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
7911971569
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2014-03-31
First name - owner
JACK
Middle name - owner
W
Last name - owner
WAGNER
Title - owner
ASST SECRETARY
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
8729046537
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2014-03-31
First name - owner
BRIAN
Middle name - owner
S
Last name - owner
REINER
Title - owner
CHAIRMAN OF THE BOARD
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
8729046537
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-03-31
First name - owner
BRIAN
Middle name - owner
S
Last name - owner
REINER
Title - owner
CHAIRMAN OF THE BOARD
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
8921185257
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-05-05
First name - owner
ROBERT
Middle name - owner
A
Last name - owner
CHERRY
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
9032385794
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2011-09-19
First name - owner
LARRY
Middle name - owner
L
Last name - owner
INNOCENT
Title - owner
BOARD MEMBER
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
9537077292
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
1980-06-16
Organization name - owner
ADVENTIST HEALTH SYSTEM/WEST
Doing business as name - owner
ADVENTIST HEALTH
Address line 1 - owner
2100 DOUGLAS BLVD
City - owner
ROSEVILLE
State - owner
CA
Zip code - owner
956613804
Percentage ownership
100
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
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
9537077292
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
1980-06-16
Organization name - owner
ADVENTIST HEALTH SYSTEM/WEST
Doing business as name - owner
ADVENTIST HEALTH
Address line 1 - owner
2100 DOUGLAS BLVD
City - owner
ROSEVILLE
State - owner
CA
Zip code - owner
956613804
Percentage ownership
100
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
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
9638137441
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1999-09-14
First name - owner
WARREN
Last name - owner
TETZ
Title - owner
ASSISANT SECRETARY
Enrollment id
O20170717002101
Associate id
4284692096
Organization name
GLENDALE ADVENTIST MEDICAL CENTER
Associate id - owner
9638137441
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
1999-09-14
First name - owner
WARREN
Last name - owner
TETZ
Title - owner
SR VP OPERATIONS/COO

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