Public record

CMS Hospice All Owners

Associate id - owner: 7012170269 · 6 matching records

Enrollment id
O20210503000008
Associate id
9032528161
Organization name
SHINING LIGHT LLC
Associate id - owner
7012170269
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2020-07-14
First name - owner
SHAHAB
Last name - owner
MOKHTARE
Title - owner
MEDICAL DIRECTOR
Percentage ownership
50
Enrollment id
O20210503000008
Associate id
9032528161
Organization name
SHINING LIGHT LLC
Associate id - owner
7012170269
Type - owner
I
Role code - owner
37
Role text - owner
5% OR GREATER SECURITY INTEREST
Association date - owner
2020-07-14
First name - owner
SHAHAB
Last name - owner
MOKHTARE
Percentage ownership
50
Enrollment id
O20210503000008
Associate id
9032528161
Organization name
SHINING LIGHT LLC
Associate id - owner
7012170269
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2020-07-14
First name - owner
SHAHAB
Last name - owner
MOKHTARE
Title - owner
BOARD MEMBER
Enrollment id
O20210503000008
Associate id
9032528161
Organization name
SHINING LIGHT LLC
Associate id - owner
7012170269
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2021-01-01
First name - owner
SHAHAB
Last name - owner
MOKHTARE
Title - owner
MD;
Enrollment id
O20210604000325
Associate id
5395144711
Organization name
SIENA HOSPICE, LLC
Associate id - owner
7012170269
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2020-12-09
First name - owner
SHAHAB
Last name - owner
MOKHTARE
Title - owner
MEDICAL DIRECTOR
Percentage ownership
50
Enrollment id
O20210604000325
Associate id
5395144711
Organization name
SIENA HOSPICE, LLC
Associate id - owner
7012170269
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2020-12-09
First name - owner
SHAHAB
Last name - owner
MOKHTARE
Title - owner
MD;
Percentage ownership
50

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