200 Lighthouse, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 2668712258 Enrollment ID O20190318002629

Details

Linked facilitiesFacilities
1
StatesStates
1

11 parties: 1 organizations · 10 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Justin Missbach4789167081IndividualOperational/Managerial Control; ADP of the SNF
Marisela Diaz7315420619IndividualOperational/Managerial Control; ADP of the SNF
Zachariah Flores2961985262IndividualOperational/Managerial Control; ADP of the SNF
Nischal Thapa1456837541IndividualOperational/Managerial Control; ADP of the SNF
Laura Renee Avalos-ackerman3870076177IndividualOperational/Managerial Control; ADP of the SNF
Ryan Taylor8527546472IndividualOperational/Managerial Control; ADP of the SNF
Ravi Chinthakindi5395890479IndividualOperational/Managerial Control; ADP of the SNF
Redentor Batin Calabazaron2365928454IndividualOperational/Managerial Control; ADP of the SNF
Bvhc, LLC1355680588Organization5% or Greater Direct Ownership Interest100
Bryan Boehrer4688985708Individual5% or Greater Indirect Ownership Interest50
Richard Martin8527296896Individual5% or Greater Indirect Ownership Interest50

Linked facilities

Facility Location % Own. HPRD Ratings Census Flags
Oceanview Post Acute
200 Lighthouse, LLC
47 residents
Other disclo…
4.04Ovr★★★★★Stf★★★★Ins★★★★QM★★★★★47
  • 200 Lighthouse, LLC
    Other disclosed role47 res4.04 HPRD
    Overall 5Staffing Staff 4

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
02/16/2019Oceanview Post Acute200 Lighthouse, LLCP.G.H.C.C., IncBuyer
  1. 02/16/2019
    P.G.H.C.C., Inc200 Lighthouse, LLC
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to 200 Lighthouse, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.