Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 0749191013 · 3 matching records

Enrollment id
O20181207000751
Associate id
6204170533
Organization name
KINGSTON NH OPERATION LLC
Associate id - owner
0749191013
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2018-10-01
First name - owner
KATHRYN
Middle name - owner
E
Last name - owner
PEREZ
Title - owner
LNHA
Enrollment id
O20251027001913
Associate id
1355830803
Organization name
PALMER AVENUE SNF OPERATIONS LLC
Associate id - owner
0749191013
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2025-08-04
First name - owner
KATHRYN
Middle name - owner
E
Last name - owner
PEREZ
Percentage ownership
5
Enrollment id
O20251027001913
Associate id
1355830803
Organization name
PALMER AVENUE SNF OPERATIONS LLC
Associate id - owner
0749191013
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-08-04
First name - owner
KATHRYN
Middle name - owner
E
Last name - owner
PEREZ

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