Doheny Beach, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 1052823614 Enrollment ID O20250620001342

Details

Linked facilitiesFacilities
1
StatesStates
1

8 parties: 1 organizations · 7 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Ryan Williams6002043015Individual5% or Greater Indirect Ownership Interest; Corporate Officer; Operational/Managerial Control44.05
Scott Clawson0648409938Individual5% or Greater Indirect Ownership Interest; Corporate Officer; Operational/Managerial Control44.05
Benita Wilson3971015553IndividualOperational/Managerial Control; ADP of the SNF
Mark Sanders5799903563IndividualOperational/Managerial Control; ADP of the SNF
Tracy Berg6305831439IndividualOperational/Managerial Control; ADP of the SNF
Kalesta Healthcare Group, LLC7810240488Organization5% or Greater Direct Ownership Interest100
Micah Porter1658750799Individual5% or Greater Indirect Ownership Interest7
Scott Clawson4385644368IndividualIndirect Ownership Interest4.9

Linked facilities

Facility Location % Own. HPRD Ratings Census Flags
Othello Post Acute
Doheny Beach, LLC
35 residents
Other disclo…
3.51Ovr★★★☆☆Stf★★★☆☆Ins★★★☆☆QM★★★☆☆35
  • Doheny Beach, LLC
    Other disclosed role35 res3.51 HPRD
    Overall 3Staffing Staff 3

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
06/01/2025Othello Post AcuteDoheny Beach, LLCOthello Nursing & Rehab LLCBuyer
  1. 06/01/2025
    Othello Nursing & Rehab LLCDoheny Beach, LLC
Related CMS associates

FEC political contributions FEC contributions Beta

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