Pine Knoll Nursing Home, Inc

Enrollment entity
Provider / enrollment organization Enrollment PAC 3274636923 Enrollment ID O20070316000429

Details

Linked facilitiesFacilities
1
StatesStates
1

16 parties: 4 organizations · 12 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Patricia Russell5890729768Individual5% or Greater Direct Ownership Interest; 5% or Greater Security Interest; General Partnership Interest50
Travis B Bergeron3577087741IndividualCorporate Officer; Operational/Managerial Control; ADP of the SNF0
Maria Fatigati9436176971IndividualOperational/Managerial Control; ADP of the SNF
Francis E Cheney Jr Estate1850815028Organization5% or Greater Direct Ownership Interest; ADP of the SNF50
Holly A Cummings1759805922IndividualCorporate Officer; ADP of the SNF
Dale Atwood6204350473IndividualCorporate Officer; ADP of the SNF
Warren Rice2668996836IndividualCorporate Officer; ADP of the SNF
Unknown party3678097847OrganizationADP of the SNF
Unknown party6305360579OrganizationADP of the SNF
Unknown party1759805930IndividualADP of the SNF
Unknown party8022532209IndividualADP of the SNF
Unknown party9931623113IndividualADP of the SNF
Unknown party4486178654IndividualADP of the SNF
Wells Fargo Bank, N.a.5092754747Organization5% or Greater Mortgage Interest74
Unknown party7719462597IndividualTrustee of the SNF
Unknown party8628553401IndividualTrustee of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Pines Rehab & Health Center
Pine Knoll Nursing Home, Inc
56 residents
Other disclo…
4.42Ovr★★★★Stf★★★★Ins★★★★QM★★☆☆☆56
  • Pine Knoll Nursing Home, Inc
    Other disclosed role56 res4.42 HPRD
    Overall 4Staffing Staff 4
Related CMS associates

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Name match to Pine Knoll Nursing Home, Inc in FEC filings. Similar names may appear—confirm on FEC.gov.