Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 0840334264 · 3 matching records

Enrollment id
O20040507001025
Associate id
8325037187
Organization name
OAKHAVEN NURSING CENTER LLC
Associate id - owner
0840334264
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2016-09-12
First name - owner
KELLY
Last name - owner
PRUITT
Title - owner
EXECUTIVE DIRECTOR
Percentage ownership
50
Enrollment id
O20240125002659
Associate id
5395198360
Organization name
BENNETTSVILLE HEALTH CARE LLC
Associate id - owner
0840334264
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2023-06-01
First name - owner
KELLY
Last name - owner
PRUITT
Title - owner
ADMINISTRATOR
Enrollment id
O20250916004562
Associate id
7113421827
Organization name
515 WARLEY OPCO LLC
Associate id - owner
0840334264
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-09-23
First name - owner
KELLY
Last name - owner
PRUITT

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