Public record

CMS Skilled Nursing Facility All Owners

Associate id: 6204114796 · 17 matching records

Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
0345696944
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-08-01
Organization name - owner
ROYAL REHAB SOUTH
Doing business as name - owner
ROYAL REHAB SOUTH LLC
Address line 1 - owner
3004 AVENUE L
City - owner
BROOKLYN
State - owner
NY
Zip code - owner
112104737
Percentage ownership
38.43
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
0345696944
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-08-01
Organization name - owner
ROYAL REHAB SOUTH
Doing business as name - owner
ROYAL REHAB SOUTH LLC
Address line 1 - owner
3004 AVENUE L
City - owner
BROOKLYN
State - owner
NY
Zip code - owner
112104737
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
1254787856
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-08-01
Organization name - owner
MAXIMUS RRS LLC
Address line 1 - owner
200 2ND ST NW
Address line 2 - owner
STE 300
City - owner
HICKORY
State - owner
NC
Zip code - owner
286014933
Percentage ownership
11.58
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
1254787856
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-08-01
Organization name - owner
MAXIMUS RRS LLC
Address line 1 - owner
200 2ND ST NW
Address line 2 - owner
STE 300
City - owner
HICKORY
State - owner
NC
Zip code - owner
286014933
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
2163878760
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2016-09-28
Organization name - owner
LAKE PARK MAX HOLDINGS LLC
Address line 1 - owner
259 SW CAPTAIN BROWN RD
City - owner
MADISON
State - owner
FL
Zip code - owner
323404316
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
2466930722
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-08-01
Address line 1 - owner
200 2ND ST NW
Address line 2 - owner
STE 300
City - owner
HICKORY
State - owner
NC
Zip code - owner
286014933
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
3072969674
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-01-08
First name - owner
ASHLEY
Last name - owner
SEVOR
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
3072969674
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
First name - owner
ASHLEY
Last name - owner
SEVOR
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
3375701816
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-07-01
First name - owner
WILLIAM
Middle name - owner
LANTZ
Last name - owner
EFFINGER
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
4284112541
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-08-01
Address line 1 - owner
200 2ND ST NW
Address line 2 - owner
FL 200
City - owner
HICKORY
State - owner
NC
Zip code - owner
286014933
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
5193203453
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-11-21
Address line 1 - owner
200 2ND ST NW
Address line 2 - owner
FL 200
City - owner
HICKORY
State - owner
NC
Zip code - owner
286014933
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
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
5294038808
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2016-09-21
First name - owner
NISSON
Last name - owner
HIRSCH
Percentage ownership
10
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
5294038808
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-08-01
First name - owner
NISSON
Last name - owner
HIRSCH
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
7315085636
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2016-02-08
First name - owner
YISROEL
Last name - owner
BORNSTEIN
Percentage ownership
20
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
7315085636
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-08-01
First name - owner
YISROEL
Last name - owner
BORNSTEIN
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
9436505039
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-04-01
Organization name - owner
LBS CAPITAL HOLDINGS LLC
Address line 1 - owner
1285 E 23RD ST
City - owner
BROOKLYN
State - owner
NY
Zip code - owner
112104520
Percentage ownership
20
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
N
Enrollment id
O20161104000018
Associate id
6204114796
Organization name
LAKE PARK OPERATIONS, LLC
Associate id - owner
9436505039
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-06-01
Organization name - owner
LBS CAPITAL HOLDINGS LLC
Address line 1 - owner
1285 E 23RD ST
City - owner
BROOKLYN
State - owner
NY
Zip code - owner
112104520
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

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