Crownsville Health Care LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 1456635127 Enrollment ID O20170223001837

Linked facilitiesFacilities

StatesStates

5 parties: 3 organizations · 2 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Charles Woodbury	1254656762	Individual	Corporate Officer; W-2 Managing Employee	0
Maryland Long Term Care LLC	1355328592	Organization	5% or Greater Direct Ownership Interest	100
Thi of Baltimore, Inc.	9234049222	Organization	5% or Greater Indirect Ownership Interest	100
Hunt Valley Holdings LLC	9234149113	Organization	5% or Greater Indirect Ownership Interest	100
Murray Forman	4789622614	Individual	5% or Greater Indirect Ownership Interest	—

Charles WoodburyPAC 1254656762
Individual0Corporate Officer; W-2 Managing Employee
Maryland Long Term Care LLCPAC 1355328592
Organization1005% or Greater Direct Ownership Interest
Thi of Baltimore, Inc.PAC 9234049222
Organization1005% or Greater Indirect Ownership Interest
Hunt Valley Holdings LLCPAC 9234149113
Organization1005% or Greater Indirect Ownership Interest
Murray FormanPAC 4789622614
Individual5% or Greater Indirect Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Fairfield Nursing & Rehabilitation Center Crownsville Health Care LLC 65 residents		Other disclo…	3.57	Ovr★★☆☆☆Stf★★★★☆Ins★★☆☆☆QM★★★☆☆	65

Fairfield Nursing & Rehabilitation Center
Crownsville Health Care LLC
Other disclosed role65 res3.57 HPRD
Overall 2Staffing Staff 4

Related CMS associates

Name match to Crownsville Health Care LLC in FEC filings. Similar names may appear—confirm on FEC.gov.