Public record

CMS Home Health Agency All Owners

Associate id - owner: 8729409354 · 4 matching records

Enrollment id
O20200605001237
Associate id
0547681165
Organization name
ICARE HOME HEALTH AGENCY LLC
Associate id - owner
8729409354
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2019-12-06
First name - owner
FAHRREN
Last name - owner
BOLASTIG
Percentage ownership
100
Enrollment id
O20200605001237
Associate id
0547681165
Organization name
ICARE HOME HEALTH AGENCY LLC
Associate id - owner
8729409354
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2019-12-06
First name - owner
FAHRREN
Last name - owner
BOLASTIG
Title - owner
PRESIDENT, BOARD MEMBER
Enrollment id
O20200605001237
Associate id
0547681165
Organization name
ICARE HOME HEALTH AGENCY LLC
Associate id - owner
8729409354
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-12-06
First name - owner
FAHRREN
Last name - owner
BOLASTIG
Title - owner
PRESIDENT, BOARD MEMBER
Enrollment id
O20200605001237
Associate id
0547681165
Organization name
ICARE HOME HEALTH AGENCY LLC
Associate id - owner
8729409354
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2019-12-06
First name - owner
FAHRREN
Last name - owner
BOLASTIG
Title - owner
PRESIDENT, BOARD MEMBER

This record is displayed as returned by the government data source. Open the raw file · About this dataset · Full source list