Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 9234455080 · 7 matching records

Enrollment id
O20030916000015
Associate id
9436060647
Organization name
BENEDICTINE LIVING COMMUNITIES INC
Associate id - owner
9234455080
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-01-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK
Enrollment id
O20070618000307
Associate id
4789585746
Organization name
PARKSIDE HOME
Associate id - owner
9234455080
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2024-07-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK
Percentage ownership
5
Enrollment id
O20070618000307
Associate id
4789585746
Organization name
PARKSIDE HOME
Associate id - owner
9234455080
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-07-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK
Enrollment id
O20070618000307
Associate id
4789585746
Organization name
PARKSIDE HOME
Associate id - owner
9234455080
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2024-07-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK
Enrollment id
O20070811000095
Associate id
1951218817
Organization name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Associate id - owner
9234455080
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2023-10-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK
Title - owner
MD;
Enrollment id
O20100630000278
Associate id
9436060647
Organization name
BENEDICTINE LIVING COMMUNITIES INC
Associate id - owner
9234455080
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-04-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK
Enrollment id
O20100630000278
Associate id
9436060647
Organization name
BENEDICTINE LIVING COMMUNITIES INC
Associate id - owner
9234455080
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-04-01
First name - owner
TARA
Middle name - owner
R
Last name - owner
MERTZ-HACK

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