Public record

CMS Skilled Nursing Facility All Owners

Associate id: 9436287174 · 18 matching records

Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
1850820614
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-01-01
Organization name - owner
EXTENDED CARE CLINICAL LLC
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
1850820614
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-13
Organization name - owner
EXTENDED CARE CLINICAL LLC
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
2466524202
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2020-12-31
Organization name - owner
ATIED ASSOCIATES LLC
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
Percentage ownership
16.67
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
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
2466524202
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-12-15
Organization name - owner
ATIED ASSOCIATES LLC
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
3173053162
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-01-01
Organization name - owner
ROTH & CO, LLP
Doing business as name - owner
ROTH & COMPANY, LLP
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
LLP
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
3173053162
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-13
Organization name - owner
ROTH & CO, LLP
Doing business as name - owner
ROTH & COMPANY, LLP
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
LLP
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
3870637663
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-01-01
Organization name - owner
EXTENDED CARE CONSULTING LLC
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
3870637663
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-13
Organization name - owner
EXTENDED CARE CONSULTING LLC
Address line 1 - owner
2201 MAIN ST
City - owner
EVANSTON
State - owner
IL
Zip code - owner
602021519
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
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
4880828045
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-12-01
First name - owner
JERRI
Last name - owner
SPRINGER
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
4880828045
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-12-01
First name - owner
JERRI
Last name - owner
SPRINGER
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
7517875693
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2020-12-31
First name - owner
ERIC
Last name - owner
ROTHNER
Title - owner
OWNER
Percentage ownership
33.33
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
7517875693
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-01-11
First name - owner
ERIC
Last name - owner
ROTHNER
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
8426024837
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-01-01
First name - owner
WILLIAM
Middle name - owner
H
Last name - owner
DIXON
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
8426024837
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-01-01
First name - owner
WILLIAM
Middle name - owner
H
Last name - owner
DIXON
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
8820063290
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2020-12-31
First name - owner
SHERWIN
Last name - owner
RAY
Title - owner
OWNER
Percentage ownership
50
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
8820063290
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-01-01
First name - owner
SHERWIN
Last name - owner
RAY
Title - owner
PRESIDENT
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
8820063290
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-01-01
First name - owner
SHERWIN
Last name - owner
RAY
Enrollment id
O20100517000636
Associate id
9436287174
Organization name
PRAIRIE VILLAGE HEALTHCARE CENTER INC
Associate id - owner
9335247766
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-01-01
First name - owner
DAVID
Last name - owner
ARONIN
Title - owner
MANAGER / REGISTERED AGENT

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