Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 8628219672 · 5 matching records

Enrollment id
O20031218000899
Associate id
4385541002
Organization name
LEXINGTON SQUARE LLC
Associate id - owner
8628219672
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2023-10-18
First name - owner
HALLEY
Middle name - owner
C
Last name - owner
ANDERSON
Title - owner
MEDICAL DIRETOR
Enrollment id
O20031218000899
Associate id
4385541002
Organization name
LEXINGTON SQUARE LLC
Associate id - owner
8628219672
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-04-17
First name - owner
HALLEY
Middle name - owner
C
Last name - owner
ANDERSON
Enrollment id
O20100512000228
Associate id
5092843037
Organization name
GOOD SAMARITAN HOME OF QUINCY
Associate id - owner
8628219672
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2017-06-12
First name - owner
HALLEY
Middle name - owner
C
Last name - owner
ANDERSON
Enrollment id
O20100512000228
Associate id
5092843037
Organization name
GOOD SAMARITAN HOME OF QUINCY
Associate id - owner
8628219672
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-06
First name - owner
HALLEY
Middle name - owner
C
Last name - owner
ANDERSON
Enrollment id
O20231030003658
Associate id
2264693985
Organization name
DAVES PLACE LLC
Associate id - owner
8628219672
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2023-10-18
First name - owner
HALLEY
Middle name - owner
C
Last name - owner
ANDERSON

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