Public record

CMS Skilled Nursing Facility All Owners

Associate id: 6103085477 · 9 matching records

Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
0749389393
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1994-04-15
First name - owner
DAWN
Middle name - owner
M
Last name - owner
MARSH
Title - owner
VP
Percentage ownership
15
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
1355729443
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2021-05-01
First name - owner
ALBERT
Middle name - owner
V
Last name - owner
HAWORTH
Title - owner
PRESIDENT/CEO
Percentage ownership
15
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
1355729443
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-05-01
First name - owner
ALBERT
Middle name - owner
V
Last name - owner
HAWORTH
Title - owner
PRESIDENT/CEO
Percentage ownership
5
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
1951572015
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
1989-08-01
Organization name - owner
REAL PROPERTY HEALTH FACILITIES CORP
Address line 1 - owner
9960 W CHEYENNE AVE
City - owner
LAS VEGAS
State - owner
NV
Zip code - owner
891297701
Percentage ownership
100
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
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
4688955057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2015-06-01
First name - owner
CHRISTINA
Middle name - owner
J
Last name - owner
PENN
Percentage ownership
100
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
4688955057
Type - owner
I
Role code - owner
44
Role text - owner
OTHER
Association date - owner
2015-06-01
First name - owner
CHRISTINA
Middle name - owner
J
Last name - owner
PENN
Percentage ownership
100
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
4981744570
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2020-04-16
First name - owner
CHAD
Last name - owner
SMYTH
Title - owner
REGIONAL DIRECTOR
Percentage ownership
20
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
8224200928
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2010-11-01
Organization name - owner
CHRISTINA JAYNE PENN MANAGEMENT TRUST
Address line 1 - owner
9960 W CHEYENNE AVE
Address line 2 - owner
STE 110
City - owner
LAS VEGAS
State - owner
NV
Zip code - owner
891297703
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
TRUST - CHRISTINA JAYNE PENN, TRUSTEE CH
Enrollment id
O20120306000256
Associate id
6103085477
Organization name
MIDWAY MANOR CORP
Associate id - owner
8628242435
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2015-09-16
First name - owner
DAVID
Middle name - owner
M
Last name - owner
EGAN
Title - owner
ADMINISTRATOR
Percentage ownership
50

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