Public record

CMS Skilled Nursing Facility All Owners

Associate id: 4385732841 · 42 matching records

Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0143795567
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-03-17
Address line 1 - owner
4933 OLD GREENWOOD RD
City - owner
FORT SMITH
State - owner
AR
Zip code - owner
729036906
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
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0143795567
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2009-01-01
Address line 1 - owner
4933 OLD GREENWOOD RD
City - owner
FORT SMITH
State - owner
AR
Zip code - owner
729036906
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
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0446274930
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
1999-04-26
Organization name - owner
SENIOR CARE COMMUNITIES
Doing business as name - owner
PROVIDENCE PLACE
Address line 1 - owner
161 SAINT ANTHONY AVE 825
City - owner
SAINT PAUL
State - owner
MN
Zip code - owner
551032457
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
Parent company - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0446274930
Type - owner
O
Role code - owner
71
Role text - owner
TRUSTEE OF THE SNF
Association date - owner
2007-03-01
Organization name - owner
SENIOR CARE COMMUNITIES
Doing business as name - owner
PROVIDENCE PLACE
Address line 1 - owner
161 SAINT ANTHONY AVE 825
City - owner
SAINT PAUL
State - owner
MN
Zip code - owner
551032457
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
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0446274930
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2007-03-01
Organization name - owner
SENIOR CARE COMMUNITIES
Doing business as name - owner
PROVIDENCE PLACE
Address line 1 - owner
161 SAINT ANTHONY AVE 825
City - owner
SAINT PAUL
State - owner
MN
Zip code - owner
551032457
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
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0446274930
Type - owner
O
Role code - owner
85
Role text - owner
DIRECT OWNERSHIP INTEREST
Association date - owner
2007-03-01
Organization name - owner
SENIOR CARE COMMUNITIES
Doing business as name - owner
PROVIDENCE PLACE
Address line 1 - owner
161 SAINT ANTHONY AVE 825
City - owner
SAINT PAUL
State - owner
MN
Zip code - owner
551032457
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
Parent company - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
0840765269
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-12-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
1759856172
Type - owner
I
Role code - owner
71
Role text - owner
TRUSTEE OF THE SNF
Association date - owner
2024-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
1951302975
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2019-02-28
First name - owner
SCOTT
Middle name - owner
JOHN
Last name - owner
FAIRBAIRN
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
1951302975
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-02-28
First name - owner
SCOTT
Middle name - owner
JOHN
Last name - owner
FAIRBAIRN
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
2062436561
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2011-12-07
First name - owner
SUSAN
Middle name - owner
LANDWEHR
Last name - owner
MARSHALL
Title - owner
PRESIDENT
Percentage ownership
100
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
2769957182
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-12-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
2769957182
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-12-01
Percentage ownership
100
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
2860967288
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-11-01
First name - owner
NOEL
Last name - owner
LOVAS
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
2860967288
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2021-11-01
First name - owner
NOEL
Last name - owner
LOVAS
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
3577038991
Type - owner
I
Role code - owner
39
Role text - owner
LIMITED PARTNERSHIP INTEREST
Association date - owner
2024-01-01
Percentage ownership
100
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
3678048097
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2009-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
3870068299
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-03-17
Address line 1 - owner
4547 HWY 9
City - owner
HOWELL
State - owner
NJ
Zip code - owner
077313382
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
Trust or trustee - owner
N
Other type - owner
Y
Other type text - owner
PARTNERSHIP
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
3870068299
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-12-01
Address line 1 - owner
4547 HWY 9
City - owner
HOWELL
State - owner
NJ
Zip code - owner
077313382
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
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
PARTNERSHIP
Parent company - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
4688149008
Type - owner
I
Role code - owner
71
Role text - owner
TRUSTEE OF THE SNF
Association date - owner
2025-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
4789159104
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-03-17
Address line 1 - owner
2501 BOJI BEND DR
City - owner
MILFORD
State - owner
IA
Zip code - owner
513517012
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
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
4789159104
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-12-06
Address line 1 - owner
2501 BOJI BEND DR
City - owner
MILFORD
State - owner
IA
Zip code - owner
513517012
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
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
4789783556
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2011-12-07
First name - owner
RICHARD
Last name - owner
MARTIN
Title - owner
SECRETARY
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
5395210710
Type - owner
I
Role code - owner
71
Role text - owner
TRUSTEE OF THE SNF
Association date - owner
2024-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
5496220816
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2009-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
5890203731
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-04-01
First name - owner
RYAN
Last name - owner
KING
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
5890203731
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-04-01
First name - owner
RYAN
Last name - owner
KING
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
6406321827
Type - owner
I
Role code - owner
71
Role text - owner
TRUSTEE OF THE SNF
Association date - owner
2025-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
7113492539
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2009-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
7416109475
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-01-01
First name - owner
ELLEN
Last name - owner
SIEBENALER
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
7416109475
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2021-12-26
First name - owner
ELLEN
Last name - owner
SIEBENALER
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
7618485558
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2020-06-30
Organization name - owner
LIFESPARK MANAGEMENT SERVICES
Address line 1 - owner
5320 W 23RD ST
Address line 2 - owner
STE 130
City - owner
ST LOUIS PARK
State - owner
MN
Zip code - owner
554161670
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
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
7618485558
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2020-06-30
Organization name - owner
LIFESPARK MANAGEMENT SERVICES
Address line 1 - owner
5320 W 23RD ST
Address line 2 - owner
STE 130
City - owner
ST LOUIS PARK
State - owner
MN
Zip code - owner
554161670
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
N
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
Y
Owned by another org or ind - owner
Y
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
8123593548
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2020-01-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
8123593548
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2020-01-01
Percentage ownership
100
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
8628494762
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2020-06-30
Organization name - owner
LIFESPRK HOLDINGS, INC.
Address line 1 - owner
5320 W 23RD ST
Address line 2 - owner
STE 130
City - owner
ST LOUIS PARK
State - owner
MN
Zip code - owner
554161670
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
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
Y
Owned by another org or ind - owner
N
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
9032684451
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-07-01
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
9032684451
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-07-01
Percentage ownership
100
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
9436667375
Type - owner
O
Role code - owner
38
Role text - owner
GENERAL PARTNERSHIP INTEREST
Association date - owner
2020-06-30
Organization name - owner
TWSL. LLC
Address line 1 - owner
3720 23RD AVE S
City - owner
MINNEAPOLIS
State - owner
MN
Zip code - owner
554073010
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
N
Owned by another org or ind - owner
Y
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
9436667375
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-01-01
Organization name - owner
TWSL. LLC
Address line 1 - owner
3720 23RD AVE S
City - owner
MINNEAPOLIS
State - owner
MN
Zip code - owner
554073010
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
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
9436667375
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2026-03-17
Organization name - owner
TWSL. LLC
Address line 1 - owner
3720 23RD AVE S
City - owner
MINNEAPOLIS
State - owner
MN
Zip code - owner
554073010
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
Enrollment id
O20080206000538
Associate id
4385732841
Organization name
SENIOR CARE PROVIDENCE, LLC
Associate id - owner
9931674355
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-12-01

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