Public record

CMS Skilled Nursing Facility All Owners

Associate id: 7113269044 · 24 matching records

Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
0446161152
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
First name - owner
DOUGLAS
Middle name - owner
B
Last name - owner
BOULWARE
Title - owner
33.34% VIA SDB HOLDINGS
Percentage ownership
33.34
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
0446161152
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
First name - owner
DOUGLAS
Middle name - owner
B
Last name - owner
BOULWARE
Percentage ownership
33.34
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
1052825445
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-04-01
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
1153835533
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-02
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
2062926447
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-02
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
Y
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
3476835273
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2019-04-01
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
3476835273
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-02
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
5496855793
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-02
First name - owner
DAVID
Last name - owner
COLVIN
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
5799299178
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-02
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Title - owner
33.33% VIA SDB HOLDINGS
Percentage ownership
33.33
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2019-04-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Title - owner
AUTHORIZED OFFICIAL & MANAGING M
Percentage ownership
3.33
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
5991839813
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
First name - owner
STEVEN
Middle name - owner
D
Last name - owner
BOULWARE
Percentage ownership
33.33
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
6406120690
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
Organization name - owner
SDB HOLDINGS
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
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
Y
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
6507370996
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-04-01
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
6608380084
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-07-02
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
6608380092
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-04-01
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
7416185699
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-04-18
First name - owner
CHARLES
Middle name - owner
L
Last name - owner
LEBON
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
7618492497
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-04-01
Organization name - owner
PROGRESSIVE REHAB SOLUTIONS, LLC
Address line 1 - owner
3710 RAWLINS ST
Address line 2 - owner
STE 1325
City - owner
DALLAS
State - owner
TX
Zip code - owner
752194217
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
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
8224542618
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2021-07-26
First name - owner
LATONYA
Middle name - owner
E
Last name - owner
GREGGS
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
8325552706
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-04-01
Address line 1 - owner
905 CALLE AMANECER
Address line 2 - owner
STE 300
City - owner
SAN CLEMENTE
State - owner
CA
Zip code - owner
926736277
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
LIMITED PARTNERSHIP
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
9234643610
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2019-04-01
Address line 1 - owner
905 CALLE AMANECER
Address line 2 - owner
STE 300
City - owner
SAN CLEMENTE
State - owner
CA
Zip code - owner
926736277
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
Y
Chain home office - owner
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
9436335668
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
First name - owner
WILLIAM
Middle name - owner
M
Last name - owner
BAUDER
Title - owner
33.33% VIA SDB HOLDINGS
Percentage ownership
33.33
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
9436335668
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2019-04-01
First name - owner
WILLIAM
Middle name - owner
M
Last name - owner
BAUDER
Title - owner
MANAGING MEMBER
Percentage ownership
33.33
Enrollment id
O20190425000544
Associate id
7113269044
Organization name
PMG OPCO-SPRINGLAKE LLC
Associate id - owner
9436335668
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2019-04-01
First name - owner
WILLIAM
Middle name - owner
M
Last name - owner
BAUDER
Percentage ownership
33.33

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