Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 5395776553 · 10 matching records

Enrollment id
O20050802000619
Associate id
0749218584
Organization name
COUNTRYSIDE HEALTH SERVICES LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2024-09-01
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Title - owner
SECRETARY
Percentage ownership
50
Enrollment id
O20050802000619
Associate id
0749218584
Organization name
COUNTRYSIDE HEALTH SERVICES LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2000-11-27
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Title - owner
VICE PRESIDENT
Percentage ownership
25
Enrollment id
O20050802000619
Associate id
0749218584
Organization name
COUNTRYSIDE HEALTH SERVICES LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-09-01
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Enrollment id
O20170215000611
Associate id
7911280052
Organization name
RIVERSIDE HEALTH SERVICES LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2016-08-15
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Title - owner
SECRETARY
Percentage ownership
50
Enrollment id
O20170215000611
Associate id
7911280052
Organization name
RIVERSIDE HEALTH SERVICES LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-09-01
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Enrollment id
O20260113000881
Associate id
6103125653
Organization name
THREE OAKS, LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2024-09-27
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Title - owner
MANAGER
Enrollment id
O20260113000881
Associate id
6103125653
Organization name
THREE OAKS, LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2025-09-27
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Percentage ownership
50
Enrollment id
O20260113000881
Associate id
6103125653
Organization name
THREE OAKS, LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-09-01
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Enrollment id
O20260113000881
Associate id
6103125653
Organization name
THREE OAKS, LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-09-01
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Enrollment id
O20260113000881
Associate id
6103125653
Organization name
THREE OAKS, LLC
Associate id - owner
5395776553
Type - owner
I
Role code - owner
85
Role text - owner
DIRECT OWNERSHIP INTEREST
Association date - owner
2025-09-01
First name - owner
JUSTIN
Middle name - owner
TODD
Last name - owner
ROGERS
Percentage ownership
50

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