Public record

CMS Skilled Nursing Facility All Owners

Associate id: 5799157590 · 50 matching records

Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0446161152
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
DOUGLAS
Middle name - owner
B
Last name - owner
BOULWARE
Percentage ownership
6.25
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0446161152
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
DOUGLAS
Middle name - owner
B
Last name - owner
BOULWARE
Percentage ownership
6.25
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0446161152
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
DOUGLAS
Middle name - owner
B
Last name - owner
BOULWARE
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0446384366
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
KATIE
Middle name - owner
B
Last name - owner
WALKER
Percentage ownership
12.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0446384366
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
KATIE
Middle name - owner
B
Last name - owner
WALKER
Percentage ownership
12.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0446384366
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
KATIE
Middle name - owner
B
Last name - owner
WALKER
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0648609412
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
ROGENMOSER D'VILLE LLC
Address line 1 - owner
PO BOX 12064
City - owner
ALEXANDRIA
State - owner
LA
Zip code - owner
71315
Percentage ownership
10
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0648609412
Type - owner
O
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
Organization name - owner
ROGENMOSER D'VILLE LLC
Address line 1 - owner
PO BOX 12064
City - owner
ALEXANDRIA
State - owner
LA
Zip code - owner
71315
Percentage ownership
10
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
0648609412
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
Organization name - owner
ROGENMOSER D'VILLE LLC
Address line 1 - owner
PO BOX 12064
City - owner
ALEXANDRIA
State - owner
LA
Zip code - owner
71315
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1153571195
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
BOULWARE D'VILLE LLC
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
Percentage ownership
50
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1153571195
Type - owner
O
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
Organization name - owner
BOULWARE D'VILLE LLC
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
Percentage ownership
50
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1153571195
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
Organization name - owner
BOULWARE D'VILLE LLC
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1355252065
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
ROBERT
Middle name - owner
P
Last name - owner
ROGENMOSER
Percentage ownership
8
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1355252065
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
ROBERT
Middle name - owner
P
Last name - owner
ROGENMOSER
Percentage ownership
8
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1355252065
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
ROBERT
Middle name - owner
P
Last name - owner
ROGENMOSER
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1355475278
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
THOMAS
Middle name - owner
C
Last name - owner
BOULWARE
Percentage ownership
12.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1355475278
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
THOMAS
Middle name - owner
C
Last name - owner
BOULWARE
Percentage ownership
12.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1355475278
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
THOMAS
Middle name - owner
C
Last name - owner
BOULWARE
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1557853678
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
1557853678
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
Percentage ownership
2.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2062662000
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
CKF HOLDINGS LLC
Address line 1 - owner
118 CARONDELET CT
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711115478
Percentage ownership
5
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2062662000
Type - owner
O
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
Organization name - owner
CKF HOLDINGS LLC
Address line 1 - owner
118 CARONDELET CT
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711115478
Percentage ownership
5
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2062662000
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
Organization name - owner
CKF HOLDINGS LLC
Address line 1 - owner
118 CARONDELET CT
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711115478
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2163500364
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
CHRISTOPHER
Last name - owner
WRIGHT
Percentage ownership
5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2163500364
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
CHRISTOPHER
Last name - owner
WRIGHT
Percentage ownership
5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2163500364
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
CHRISTOPHER
Last name - owner
WRIGHT
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
2365934486
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3072038843
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
Organization name - owner
BRIDGEPOINTE FINANICAL SERVICES, LLC
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3173015294
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Address line 1 - owner
127 W BROAD ST
Address line 2 - owner
STE 800
City - owner
LAKE CHARLES
State - owner
LA
Zip code - owner
706014297
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3375035496
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3375035496
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
Percentage ownership
2.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3476835273
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-01-01
Organization name - owner
PRIORITY MANAGEMENT GROUP, LLC
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
Percentage ownership
100
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
N
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3476835273
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Organization name - owner
PRIORITY MANAGEMENT GROUP, LLC
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
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
N
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3870544471
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
SANDRA
Last name - owner
BOULWARE
Percentage ownership
6.25
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3870544471
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
SANDRA
Last name - owner
BOULWARE
Percentage ownership
6.25
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
3870544471
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
SANDRA
Last name - owner
BOULWARE
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
4082106109
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Address line 1 - owner
127 W BROAD ST
Address line 2 - owner
STE 800
City - owner
LAKE CHARLES
State - owner
LA
Zip code - owner
706014297
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
4284126301
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
4385073154
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
CENTERMARK MANAGEMENT
Address line 1 - owner
403 MIKASA VILLA LN
City - owner
RUSTON
State - owner
LA
Zip code - owner
712702504
Percentage ownership
10
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
4385073154
Type - owner
O
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
Organization name - owner
CENTERMARK MANAGEMENT
Address line 1 - owner
403 MIKASA VILLA LN
City - owner
RUSTON
State - owner
LA
Zip code - owner
712702504
Percentage ownership
10
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
4385073154
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
Organization name - owner
CENTERMARK MANAGEMENT
Address line 1 - owner
403 MIKASA VILLA LN
City - owner
RUSTON
State - owner
LA
Zip code - owner
712702504
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5193217214
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991297012
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Address line 1 - owner
1000 CHINABERRY DR
Address line 2 - owner
STE 200
City - owner
BOSSIER CITY
State - owner
LA
Zip code - owner
711112443
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
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Title - owner
MANAGING MEMBER
Percentage ownership
5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Title - owner
MANAGING MEMBER
Percentage ownership
12.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2023-01-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Percentage ownership
17.5
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-01-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Title - owner
MANAGING MEMBER
Percentage ownership
100
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-01-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Title - owner
MANAGING MEMBER
Percentage ownership
100
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-01-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Enrollment id
O20230203001222
Associate id
5799157590
Organization name
DVILLE OPCO LLC
Associate id - owner
6800707514
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2023-01-01
First name - owner
GREGORY
Last name - owner
LORD
Percentage ownership
10

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