4621 Corporation

Enrollment entity
Provider / enrollment organization Enrollment PAC 3173876521 Enrollment ID O20181101000002

Details

Linked facilitiesFacilities
1
StatesStates
1

13 parties: 7 organizations · 6 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Jacqueline Gully3779068796IndividualOperational/Managerial Control; ADP of the SNF
Renith F Viloria6507293990IndividualOperational/Managerial Control; ADP of the SNF
Bharat K Shah7012809767IndividualOperational/Managerial Control; ADP of the SNF
Peter J O'BRIEN, Sr Gift Descendants Trust7911241294Organization5% or Greater Direct Ownership Interest36.97
Bridget Stumpf Gift Descendants Trust4082958269Organization5% or Greater Direct Ownership Interest; ADP of the SNF16.09
Charles F Stumpf, Jr. Gift Descendants Trust6800130188Organization5% or Greater Direct Ownership Interest; ADP of the SNF16.09
Caitlin O'BRIEN Gift Descendants Trust8628312907Organization5% or Greater Direct Ownership Interest6.23
Meghan O'BRIEN Gift Descendants Trust4183968464Organization5% or Greater Direct Ownership Interest6.23
Reenie O'BRIEN Gift Descendants Trust4284978560Organization5% or Greater Direct Ownership Interest6.23
Peter J O'brien2567674211IndividualCorporate Officer; Corporate Director; ADP of the SNF100, 1
Unknown party1951886977IndividualADP of the SNF
Unknown party2860977881IndividualADP of the SNF
Unknown party3870078892OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Mado Healthcare - Uptown
4621 Corporation
112 residents
Other disclo…
2.87Ovr☆☆☆☆Stf☆☆☆☆Ins★★★☆☆QM☆☆☆☆112
  • 4621 Corporation
    Other disclosed role112 res2.87 HPRD
    Overall 1Staffing Staff 1
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to 4621 Corporation in FEC filings. Similar names may appear—confirm on FEC.gov.