- Enrollment id
- O20120306000478
- Associate id
- 0749449049
- Organization name
- HAWTHORNE HEALTHCARE & WELLNESS CENTRE, LP
- Associate id - owner
- 2365410727
- Type - owner
- I
- Role code - owner
- 43
- Role text - owner
- OPERATIONAL/MANAGERIAL CONTROL
- Association date - owner
- 2021-10-01
- First name - owner
- MEHRAN
- Last name - owner
- SOUREHNISSANI
- Enrollment id
- O20120306000478
- Associate id
- 0749449049
- Organization name
- HAWTHORNE HEALTHCARE & WELLNESS CENTRE, LP
- Associate id - owner
- 2365410727
- Type - owner
- I
- Role code - owner
- 72
- Role text - owner
- ADP OF THE SNF
- Association date - owner
- 2021-10-01
- First name - owner
- MEHRAN
- Last name - owner
- SOUREHNISSANI