Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 4486561057 · 31 matching records

Enrollment id
O20120801000898
Associate id
9133375454
Organization name
PINE RIDGE NURSING AND REHABILITATION, INC.
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20120801000898
Associate id
9133375454
Organization name
PINE RIDGE NURSING AND REHABILITATION, INC.
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2022-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20120801000898
Associate id
9133375454
Organization name
PINE RIDGE NURSING AND REHABILITATION, INC.
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20121022000379
Associate id
5597915942
Organization name
SIENNA HILLS NURSING & REHABILITATION, INC.
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20121022000379
Associate id
5597915942
Organization name
SIENNA HILLS NURSING & REHABILITATION, INC.
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2022-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20121022000379
Associate id
5597915942
Organization name
SIENNA HILLS NURSING & REHABILITATION, INC.
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20130717000638
Associate id
6608016563
Organization name
BOWERSTON HILLS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2015-03-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20130717000638
Associate id
6608016563
Organization name
BOWERSTON HILLS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2013-04-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20130717000638
Associate id
6608016563
Organization name
BOWERSTON HILLS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2013-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Enrollment id
O20130717000638
Associate id
6608016563
Organization name
BOWERSTON HILLS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2013-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CHAIRMAN OF THE BOARD
Enrollment id
O20130717000638
Associate id
6608016563
Organization name
BOWERSTON HILLS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2013-05-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Enrollment id
O20131122001981
Associate id
5597991455
Organization name
ROSELAWN GARDENS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2015-03-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20131122001981
Associate id
5597991455
Organization name
ROSELAWN GARDENS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2013-08-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20131122001981
Associate id
5597991455
Organization name
ROSELAWN GARDENS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2013-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Enrollment id
O20131122001981
Associate id
5597991455
Organization name
ROSELAWN GARDENS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2022-03-23
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
LLC MANAGER
Enrollment id
O20131122001981
Associate id
5597991455
Organization name
ROSELAWN GARDENS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2013-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Enrollment id
O20131122001981
Associate id
5597991455
Organization name
ROSELAWN GARDENS HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2013-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
75
Enrollment id
O20141113002004
Associate id
8628290251
Organization name
MCKENNA HEALTH CARE OF PORTSMOUTH INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2017-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20141113002004
Associate id
8628290251
Organization name
MCKENNA HEALTH CARE OF PORTSMOUTH INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2017-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20141113002004
Associate id
8628290251
Organization name
MCKENNA HEALTH CARE OF PORTSMOUTH INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20141114000345
Associate id
3779705314
Organization name
MCKENNA HEALTH CARE OF FRANKLIN FURNACE INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2015-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
ADMINISTRATOR
Enrollment id
O20141114000345
Associate id
3779705314
Organization name
MCKENNA HEALTH CARE OF FRANKLIN FURNACE INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2015-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20141114000345
Associate id
3779705314
Organization name
MCKENNA HEALTH CARE OF FRANKLIN FURNACE INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2015-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20141114000345
Associate id
3779705314
Organization name
MCKENNA HEALTH CARE OF FRANKLIN FURNACE INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
DIRECTOR
Enrollment id
O20141114000345
Associate id
3779705314
Organization name
MCKENNA HEALTH CARE OF FRANKLIN FURNACE INC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2015-09-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20160503002500
Associate id
7911206511
Organization name
CRYSTAL CARE OF IRONTON, LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2016-02-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Enrollment id
O20160503002500
Associate id
7911206511
Organization name
CRYSTAL CARE OF IRONTON, LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2016-02-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20160503002500
Associate id
7911206511
Organization name
CRYSTAL CARE OF IRONTON, LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2016-02-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO
Enrollment id
O20180423000352
Associate id
8628331881
Organization name
BLUE CREEK HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2018-03-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Percentage ownership
60
Enrollment id
O20180423000352
Associate id
8628331881
Organization name
BLUE CREEK HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2018-03-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO / MANAGER
Percentage ownership
0
Enrollment id
O20180423000352
Associate id
8628331881
Organization name
BLUE CREEK HEALTHCARE LLC
Associate id - owner
4486561057
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2018-03-01
First name - owner
PAUL
Middle name - owner
B
Last name - owner
BERGSTEN
Title - owner
CEO / MANAGER
Percentage ownership
0

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