Tacoma Rehab, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 0244333169 Enrollment ID O20070314000417

Details

Linked facilitiesFacilities
1
StatesStates
1

45 parties: 15 organizations · 30 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Midcap Finco LLC2961915988Organization5% or Greater Security Interest; Operational/Managerial Control100
Shelby Strider9830689132IndividualOperational/Managerial Control; ADP of the SNF
Katherine Fowler2163926841IndividualOperational/Managerial Control; ADP of the SNF
Justin Polson5496056632IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Yolanda Presley7113435876IndividualOperational/Managerial Control; ADP of the SNF
Misty Dawn Reid7911314299IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Anthony Brooks1658861950IndividualOperational/Managerial Control; ADP of the SNF
Andrew Simpson2769927185IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Mary Kofstad6800962614IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Stacy Poirier4385134683IndividualOperational/Managerial Control; ADP of the SNF
Jolynn Munro7214445972IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Joshua B Kretchmar6507157575IndividualOperational/Managerial Control; ADP of the SNF
Mary Mckinney2567952864IndividualOperational/Managerial Control; ADP of the SNF
Loriel Fanunal5698279420IndividualOperational/Managerial Control; ADP of the SNF
Michele Powelson6305354069IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Avamere Health Services LLC3971635988OrganizationOperational/Managerial Control; ADP of the SNF
Avamere Skilled Advisors LLC0244551661OrganizationOperational/Managerial Control; ADP of the SNF
Damien Haskins9335572080IndividualManaging Control - Governing Body; ADP of the SNF
Amanda Sanders8224569199IndividualManaging Control - Governing Body
Glen Robert Cavallo3072421676IndividualManaging Control - Governing Body
Ike Okoli4789025479IndividualManaging Control - Governing Body
Tonia Hoskins6709272743IndividualManaging Control - Governing Body; ADP of the SNF
Carrie Vanderzanden9830607597IndividualManaging Control - Governing Body; ADP of the SNF
Cody Feakin7810239688IndividualManaging Control - Governing Body; ADP of the SNF
Michelle Funderberg1153839816IndividualManaging Control - Governing Body; ADP of the SNF
Show all 45 parties (20 more)
NameOwner/control PACTypeRole(s)%
Midcap Finco LLC2961915988Organization5% or Greater Security Interest; Operational/Managerial Control100
Shelby Strider9830689132IndividualOperational/Managerial Control; ADP of the SNF
Katherine Fowler2163926841IndividualOperational/Managerial Control; ADP of the SNF
Justin Polson5496056632IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Yolanda Presley7113435876IndividualOperational/Managerial Control; ADP of the SNF
Misty Dawn Reid7911314299IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Anthony Brooks1658861950IndividualOperational/Managerial Control; ADP of the SNF
Andrew Simpson2769927185IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Mary Kofstad6800962614IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Stacy Poirier4385134683IndividualOperational/Managerial Control; ADP of the SNF
Jolynn Munro7214445972IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Joshua B Kretchmar6507157575IndividualOperational/Managerial Control; ADP of the SNF
Mary Mckinney2567952864IndividualOperational/Managerial Control; ADP of the SNF
Loriel Fanunal5698279420IndividualOperational/Managerial Control; ADP of the SNF
Michele Powelson6305354069IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Avamere Health Services LLC3971635988OrganizationOperational/Managerial Control; ADP of the SNF
Avamere Skilled Advisors LLC0244551661OrganizationOperational/Managerial Control; ADP of the SNF
Damien Haskins9335572080IndividualManaging Control - Governing Body; ADP of the SNF
Amanda Sanders8224569199IndividualManaging Control - Governing Body
Glen Robert Cavallo3072421676IndividualManaging Control - Governing Body
Ike Okoli4789025479IndividualManaging Control - Governing Body
Tonia Hoskins6709272743IndividualManaging Control - Governing Body; ADP of the SNF
Carrie Vanderzanden9830607597IndividualManaging Control - Governing Body; ADP of the SNF
Cody Feakin7810239688IndividualManaging Control - Governing Body; ADP of the SNF
Michelle Funderberg1153839816IndividualManaging Control - Governing Body; ADP of the SNF
Carolyn Staples3476053711IndividualManaging Control - Governing Body; ADP of the SNF
Colby Strunk5395253058IndividualManaging Control - Governing Body; ADP of the SNF
Kevin Hill8325556087IndividualManaging Control - Governing Body; ADP of the SNF
Todd Inskeep4789192444IndividualManaging Control - Governing Body; ADP of the SNF
Ariso LLC3072616960OrganizationDirect Ownership Interest100
Karl Rickard Miller Jr Revocable Trust3678081346OrganizationIndirect Ownership Interest100
Ari Operations, LLC2163694282OrganizationIndirect Ownership Interest100
Avamere Group LLC6507865482OrganizationIndirect Ownership Interest100
Karl Rickard Miller1355250598IndividualIndirect Ownership Interest100
Unknown party6901396290OrganizationADP of the SNF
Unknown party7719477009OrganizationADP of the SNF
Unknown party8628568912OrganizationADP of the SNF
Unknown party9537659826OrganizationADP of the SNF
Anita Scaglione1153811450IndividualADP of the SNF
Kim Games6103326442IndividualADP of the SNF
Ashley Whyte2062902364IndividualADP of the SNF
Unknown party0446740732OrganizationADP of the SNF
Unknown party5991295289OrganizationADP of the SNF
Unknown party8527558816OrganizationADP of the SNF
Unknown party1254821549OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Avamere at Pacific Ridge
Tacoma Rehab, LLC
65 residents
Other disclo…
5.16Ovr★★☆☆☆Stf★★★★Ins★★☆☆☆QM★★☆☆☆65
  • Tacoma Rehab, LLC
    Other disclosed role65 res5.16 HPRD
    Overall 2Staffing Staff 4
Related CMS associates

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Name match to Tacoma Rehab, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.