Public record

CMS Skilled Nursing Facility All Owners

Associate id: 9537223813 · 41 matching records

Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
1759876998
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-10-24
Doing business as name - owner
FORVIS MAZARS, LLP
Address line 1 - owner
910 E SAINT LOUIS ST
City - owner
SPRINGFIELD
State - owner
MO
Zip code - owner
658062580
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
ACCOUNTING FIRM
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
2961311048
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-12-01
Organization name - owner
JUCKETTE MANAGEMENT SERVICES INC
Doing business as name - owner
JUCKETTE MANAGEMENT SERVICES
Address line 1 - owner
P O BOX 588
Address line 2 - owner
13858 LIV247
City - owner
CHILLICOTHE
State - owner
MO
Zip code - owner
646010588
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
Y
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
2961311048
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2008-12-03
Organization name - owner
JUCKETTE MANAGEMENT SERVICES INC
Doing business as name - owner
JUCKETTE MANAGEMENT SERVICES
Address line 1 - owner
P O BOX 588
Address line 2 - owner
13858 LIV247
City - owner
CHILLICOTHE
State - owner
MO
Zip code - owner
646010588
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
Y
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
2961311048
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2015-12-01
Organization name - owner
JUCKETTE MANAGEMENT SERVICES INC
Doing business as name - owner
JUCKETTE MANAGEMENT SERVICES
Address line 1 - owner
P O BOX 588
Address line 2 - owner
13858 LIV247
City - owner
CHILLICOTHE
State - owner
MO
Zip code - owner
646010588
Percentage ownership
100
Created for acquisition - owner
N
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
Y
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
Parent company - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
4486149622
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-10-24
Address line 1 - owner
515 WASHINGTON ST
Address line 2 - owner
FL 2
City - owner
CHILLICOTHE
State - owner
MO
Zip code - owner
646012569
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
5395230536
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-10-24
Doing business as name - owner
PHT CONSULTING AND BILLING
Address line 1 - owner
1409 SILVER ST
City - owner
ASHLAND
State - owner
NE
Zip code - owner
680031845
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
5395703151
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-01-01
First name - owner
LOUAY
Middle name - owner
K
Last name - owner
SABIH
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
5395703151
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-01-01
First name - owner
LOUAY
Middle name - owner
K
Last name - owner
SABIH
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6204138555
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-11-03
First name - owner
HOLLY
Last name - owner
JUCKETTE
Title - owner
SECRETARY
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6204138555
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-11-03
First name - owner
HOLLY
Last name - owner
JUCKETTE
Title - owner
BOARD MEMBER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6204138555
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-11-03
First name - owner
HOLLY
Last name - owner
JUCKETTE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6204138555
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-12-01
First name - owner
HOLLY
Last name - owner
JUCKETTE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6507008877
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-07-01
First name - owner
RANDALL
Middle name - owner
A
Last name - owner
STEELE
Title - owner
BOARD MEMBER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6507008877
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-12-01
First name - owner
RANDALL
Middle name - owner
A
Last name - owner
STEELE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
6507008877
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-12-01
First name - owner
RANDALL
Middle name - owner
A
Last name - owner
STEELE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7012219363
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-11-03
First name - owner
LISA
Last name - owner
STEELE
Title - owner
VICE PRESIDENT
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7012219363
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-11-03
First name - owner
LISA
Last name - owner
STEELE
Title - owner
BOARD MEMBER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7012219363
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-12-01
First name - owner
LISA
Last name - owner
STEELE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7012219363
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-12-01
First name - owner
LISA
Last name - owner
STEELE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7012402738
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2020-11-26
First name - owner
KRISTIANNA
Last name - owner
MANSOUR
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7012402738
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2020-11-26
First name - owner
KRISTIANNA
Last name - owner
MANSOUR
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7517946502
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2014-11-05
First name - owner
JOYCE E
Last name - owner
JUCKETTE
Percentage ownership
100
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7517946502
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-11-03
First name - owner
JOYCE E
Last name - owner
JUCKETTE
Title - owner
PRESIDENT
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7517946502
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-11-11
First name - owner
JOYCE E
Last name - owner
JUCKETTE
Title - owner
BOARD MEMBER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7517946502
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2014-11-11
First name - owner
JOYCE E
Last name - owner
JUCKETTE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
7517946502
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-12-01
First name - owner
JOYCE E
Last name - owner
JUCKETTE
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
8921593641
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-02-26
First name - owner
NICHOLE
Last name - owner
BIESENTHAL
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
8921593641
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-02-26
First name - owner
NICHOLE
Last name - owner
BIESENTHAL
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9133614373
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-06-06
First name - owner
KAYANNA
Last name - owner
SHEBIEL
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9133614373
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-06-06
First name - owner
KAYANNA
Last name - owner
SHEBIEL
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9335535764
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-12-01
First name - owner
TERESA
Last name - owner
HUDLEMEYER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9335535764
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2021-12-01
First name - owner
TERESA
Last name - owner
HUDLEMEYER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9537223813
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-12-01
Organization name - owner
INDEPENDENCE MANOR INC
Doing business as name - owner
INDEPENDENCE MANOR CARE CENTER
Address line 1 - owner
1600 S KINGS HIGHWAY
City - owner
INDEPENDENCE
State - owner
MO
Zip code - owner
640551853
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
Y
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9537223813
Type - owner
O
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2008-12-03
Organization name - owner
INDEPENDENCE MANOR INC
Doing business as name - owner
INDEPENDENCE MANOR CARE CENTER
Address line 1 - owner
1600 S KINGS HIGHWAY
City - owner
INDEPENDENCE
State - owner
MO
Zip code - owner
640551853
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
Y
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9537223813
Type - owner
O
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2008-12-03
Organization name - owner
INDEPENDENCE MANOR INC
Doing business as name - owner
INDEPENDENCE MANOR CARE CENTER
Address line 1 - owner
1600 S KINGS HIGHWAY
City - owner
INDEPENDENCE
State - owner
MO
Zip code - owner
640551853
Percentage ownership
100
Created for acquisition - owner
N
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
Y
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
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9830491182
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-11-03
First name - owner
TERI
Last name - owner
NEUROTH
Title - owner
TREASURER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9830491182
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-11-03
First name - owner
TERI
Last name - owner
NEUROTH
Title - owner
BOARD MEMBER
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9830491182
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-12-01
First name - owner
TERI
Last name - owner
NEUROTH
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9830491182
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2015-12-01
First name - owner
TERI
Last name - owner
NEUROTH
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9830684554
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-02-24
First name - owner
AUDREY
Last name - owner
PLOWMAN
Enrollment id
O20090202000050
Associate id
9537223813
Organization name
INDEPENDENCE MANOR INC
Associate id - owner
9830684554
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-24
First name - owner
AUDREY
Last name - owner
PLOWMAN

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