Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 8123054939 · 5 matching records

Enrollment id
O20240220000426
Associate id
9133563042
Organization name
JACKSONVILLE OPCO LLC
Associate id - owner
8123054939
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2023-08-01
First name - owner
PHUC
Middle name - owner
V
Last name - owner
TRAN
Enrollment id
O20240220000426
Associate id
9133563042
Organization name
JACKSONVILLE OPCO LLC
Associate id - owner
8123054939
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-08-01
First name - owner
PHUC
Middle name - owner
V
Last name - owner
TRAN
Enrollment id
O20260226002845
Associate id
6507347515
Organization name
5377 JAX OPCO LLC
Associate id - owner
8123054939
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-05-01
First name - owner
PHUC
Middle name - owner
V
Last name - owner
TRAN
Enrollment id
O20260226002845
Associate id
6507347515
Organization name
5377 JAX OPCO LLC
Associate id - owner
8123054939
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2025-05-01
First name - owner
PHUC
Middle name - owner
V
Last name - owner
TRAN
Title - owner
MEDICAL DIRECTOR
Enrollment id
O20260226002845
Associate id
6507347515
Organization name
5377 JAX OPCO LLC
Associate id - owner
8123054939
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-05-01
First name - owner
PHUC
Middle name - owner
V
Last name - owner
TRAN

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