Thi of Wisconsin at Hartford, LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 1557340320 Enrollment ID O20040715000704

Linked facilitiesFacilities

StatesStates

5 parties: 3 organizations · 2 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Dawn M Gordon	7416213814	Individual	Corporate Officer; W-2 Managing Employee	—
Thi of Wisconsin, LLC	2163401944	Organization	5% or Greater Direct 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	100
Thi of Baltimore, Inc.	9234049222	Organization	5% or Greater Indirect Ownership Interest	100

Dawn M GordonPAC 7416213814
IndividualCorporate Officer; W-2 Managing Employee
Thi of Wisconsin, LLCPAC 2163401944
Organization1005% or Greater Direct Ownership Interest
Hunt Valley Holdings LLCPAC 9234149113
Organization1005% or Greater Indirect Ownership Interest
Murray FormanPAC 4789622614
Individual1005% or Greater Indirect Ownership Interest
Thi of Baltimore, Inc.PAC 9234049222
Organization1005% or Greater Indirect Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Pavilion at Glacier Valley Thi of Wisconsin at Hartford, LLC 74 residents		Other disclo…	3.49	Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★☆☆☆	74

Pavilion at Glacier Valley
Thi of Wisconsin at Hartford, LLC
Other disclosed role74 res3.49 HPRD
Overall 2Staffing Staff 3

Related CMS associates

Name match to Thi of Wisconsin at Hartford, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.