Public record

CMS Skilled Nursing Facility All Owners

Associate id: 9436408127 · 19 matching records

Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
1052506862
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-01-22
First name - owner
WILLIAM
Middle name - owner
B
Last name - owner
HOPKINS
Title - owner
DIRECTOR
Percentage ownership
50
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
1557768165
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2024-07-11
First name - owner
BRAD
Last name - owner
DALTON
Title - owner
SECRETARY
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
1557768165
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-07-11
First name - owner
BRAD
Last name - owner
DALTON
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
1557768165
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-07-11
First name - owner
BRAD
Last name - owner
DALTON
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
4486142569
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-10-02
First name - owner
DUSTIN
Last name - owner
JACKSON
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
4486142569
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-10-02
First name - owner
DUSTIN
Last name - owner
JACKSON
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
5597839167
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-10-02
First name - owner
VIJAY
Middle name - owner
N
Last name - owner
KUMAR
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
5597839167
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-10-02
First name - owner
VIJAY
Middle name - owner
N
Last name - owner
KUMAR
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
5799211835
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-07-11
First name - owner
CASSANDRA
Last name - owner
GALLANT
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
6800031006
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2018-01-22
First name - owner
THOMAS
Last name - owner
EAST
Title - owner
PRESIDENT & CEO
Percentage ownership
100
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
6800031006
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-01-22
First name - owner
THOMAS
Last name - owner
EAST
Title - owner
PRESIDENT & CEO
Percentage ownership
50
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
6800031006
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2014-04-21
First name - owner
THOMAS
Last name - owner
EAST
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
6800031006
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2014-04-21
First name - owner
THOMAS
Last name - owner
EAST
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
7911928668
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2018-01-22
Organization name - owner
AMERICAN HEALTHCARE LLC
Doing business as name - owner
AMERICAN HEALTHCARE X, LLC HERITAGE HALL-BLACKSTONE
Address line 1 - owner
3131 ELECTRIC RD
City - owner
ROANOKE
State - owner
VA
Zip code - owner
240186427
Created for acquisition - owner
N
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
N
Trust or trustee - owner
N
Other type - owner
N
Parent company - owner
N
Owned by another org or ind - owner
N
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
7911928668
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2018-01-22
Organization name - owner
AMERICAN HEALTHCARE LLC
Doing business as name - owner
AMERICAN HEALTHCARE X, LLC HERITAGE HALL-BLACKSTONE
Address line 1 - owner
3131 ELECTRIC RD
City - owner
ROANOKE
State - owner
VA
Zip code - owner
240186427
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
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
7911928668
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2018-01-22
Organization name - owner
AMERICAN HEALTHCARE LLC
Doing business as name - owner
AMERICAN HEALTHCARE X, LLC HERITAGE HALL-BLACKSTONE
Address line 1 - owner
3131 ELECTRIC RD
City - owner
ROANOKE
State - owner
VA
Zip code - owner
240186427
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
N
Trust or trustee - owner
N
Other type - owner
N
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
9032348487
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2018-01-22
First name - owner
ROBERT
Last name - owner
DALTON
Title - owner
CFO
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
9032348487
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2014-04-21
First name - owner
ROBERT
Last name - owner
DALTON
Enrollment id
O20180813003372
Associate id
9436408127
Organization name
WISE LIFE CARE, LLC
Associate id - owner
9032348487
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2014-04-21
First name - owner
ROBERT
Last name - owner
DALTON

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