Jv Jeffersonville LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 0244511590 Enrollment ID O20161229000744

Linked facilitiesFacilities

StatesStates

4 parties: 1 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Karen D Forrister	5395826119	Individual	5% or Greater Direct Ownership Interest; Corporate Officer; Operational/Managerial Control	70
Peach Health Group LLC	9436488228	Organization	Operational/Managerial Control	—
Linton Holleman	4082872734	Individual	W-2 Managing Employee	100
David K Lemcke	3577530773	Individual	5% or Greater Direct Ownership Interest; Corporate Officer	30

Karen D ForristerPAC 5395826119
Individual705% or Greater Direct Ownership Interest; Corporate Officer
Peach Health Group LLCPAC 9436488228
OrganizationOperational/Managerial Control
Linton HollemanPAC 4082872734
Individual100W-2 Managing Employee
David K LemckePAC 3577530773
Individual305% or Greater Direct Ownership Interest; Corporate Officer

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Jeffersonville Care Center LLC Jv Jeffersonville LLC 96 residents		Other disclo…	3.47	Ovr★★☆☆☆Stf★★☆☆☆Ins★★☆☆☆QM★★★☆☆	96

Jeffersonville Care Center LLC
Jv Jeffersonville LLC
Other disclosed role96 res3.47 HPRD
Overall 2Staffing Staff 2

Related CMS associates

Name match to Jv Jeffersonville LLC in FEC filings. Similar names may appear—confirm on FEC.gov.