Fountains Ccrc Holding LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 2062849284 Enrollment ID O20200228001468

Linked facilitiesFacilities

StatesStates

4 parties: 1 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Elyze Mendell	4587090246	Individual	W-2 Managing Employee	—
Sage Operations Nj LLC	4880021005	Organization	5% or Greater Direct Ownership Interest	100
Avraham H Satt	5496181158	Individual	5% or Greater Indirect Ownership Interest	50
Samuel Tennenbaum	8022444785	Individual	5% or Greater Indirect Ownership Interest; Corporate Director	50

Elyze MendellPAC 4587090246
IndividualW-2 Managing Employee
Sage Operations Nj LLCPAC 4880021005
Organization1005% or Greater Direct Ownership Interest
Avraham H SattPAC 5496181158
Individual505% or Greater Indirect Ownership Interest
Samuel TennenbaumPAC 8022444785
Individual505% or Greater Indirect Ownership Interest; Corporate Director

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
The Fountains of Atco Fountains Ccrc Holding LLC 56 residents		Other disclo…	7.70	Ovr★☆☆☆☆Stf★★☆☆☆Ins★☆☆☆☆QM★★★★☆	56

The Fountains of Atco
Fountains Ccrc Holding LLC
Other disclosed role56 res7.70 HPRD
Overall 1Staffing Staff 2

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
11/22/2019	The Fountains of Atco	Fountains Ccrc Holding LLC	The Woodlands at Hayes MILL, LLC	Buyer

11/22/2019
The Fountains of Atco (Buyer)
The Woodlands at Hayes MILL, LLC → Fountains Ccrc Holding LLC

Related CMS associates

Name match to Fountains Ccrc Holding LLC in FEC filings. Similar names may appear—confirm on FEC.gov.