Public record

CMS Skilled Nursing Facility All Owners

Associate id: 5991134280 · 12 matching records

Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
1355680208
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2020-02-26
First name - owner
NICOLE
Middle name - owner
R
Last name - owner
SMITH
Title - owner
CREDENTIALING/CONTRACTING
Percentage ownership
0
Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
6002118080
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2020-02-26
First name - owner
CHRISTOPHER
Last name - owner
LACKNER
Title - owner
MANAGER
Percentage ownership
0
Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
7416339296
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2020-12-31
Organization name - owner
ACCORD HOLDINGS, LLC
Address line 1 - owner
12680 HIGH BLUFF DR
Address line 2 - owner
STE 150
City - owner
SAN DIEGO
State - owner
CA
Zip code - owner
921302232
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
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
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
7416339296
Type - owner
O
Role code - owner
38
Role text - owner
GENERAL PARTNERSHIP INTEREST
Association date - owner
2020-12-31
Organization name - owner
ACCORD HOLDINGS, LLC
Address line 1 - owner
12680 HIGH BLUFF DR
Address line 2 - owner
STE 150
City - owner
SAN DIEGO
State - owner
CA
Zip code - owner
921302232
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
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
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
7416339296
Type - owner
O
Role code - owner
39
Role text - owner
LIMITED PARTNERSHIP INTEREST
Association date - owner
2020-12-31
Organization name - owner
ACCORD HOLDINGS, LLC
Address line 1 - owner
12680 HIGH BLUFF DR
Address line 2 - owner
STE 150
City - owner
SAN DIEGO
State - owner
CA
Zip code - owner
921302232
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
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
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
7416339296
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-19
Organization name - owner
ACCORD HOLDINGS, LLC
Address line 1 - owner
12680 HIGH BLUFF DR
Address line 2 - owner
STE 150
City - owner
SAN DIEGO
State - owner
CA
Zip code - owner
921302232
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
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
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
7810937034
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2019-09-01
First name - owner
KIYOTAKA
Middle name - owner
A
Last name - owner
YAZAWA
Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
7810937034
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-09-01
First name - owner
KIYOTAKA
Middle name - owner
A
Last name - owner
YAZAWA
Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
8426322140
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-07-24
First name - owner
EATHYN
Last name - owner
MANUMALEUNA
Title - owner
EXECUTIVE DIRECTOR/CEO
Percentage ownership
100
Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
8426322140
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-19
First name - owner
EATHYN
Last name - owner
MANUMALEUNA
Enrollment id
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
8729391396
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2020-02-26
Organization name - owner
PACIFIC HEALTHCARE VENTURES LLC
Address line 1 - owner
12680 HIGH BLUFF DR
Address line 2 - owner
STE 150
City - owner
SAN DIEGO
State - owner
CA
Zip code - owner
921302232
Percentage ownership
0
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
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
O20200408001327
Associate id
5991134280
Organization name
ISLANDS SKILLED NURSING AND REHABILITATION, LLC
Associate id - owner
8729391396
Type - owner
O
Role code - owner
85
Role text - owner
DIRECT OWNERSHIP INTEREST
Association date - owner
2020-12-31
Organization name - owner
PACIFIC HEALTHCARE VENTURES LLC
Address line 1 - owner
12680 HIGH BLUFF DR
Address line 2 - owner
STE 150
City - owner
SAN DIEGO
State - owner
CA
Zip code - owner
921302232
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
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

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