Phg Mcrae LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 3375083504 Enrollment ID O20240913002068

Details

Linked facilitiesFacilities
1
StatesStates
1

14 parties: 4 organizations · 10 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Gail B Tanner4183523434IndividualW-2 Managing Employee; Operational/Managerial Control; ADP of the SNF100
Karen D Forrister5395826119Individual5% or Greater Direct Ownership Interest; Corporate Officer; Operational/Managerial Control60
Peach Health Group LLC9436488228OrganizationOperational/Managerial Control
Brian D Siddall8325026644IndividualContracted Managing Employee
David K Lemcke3577530773Individual5% or Greater Direct Ownership Interest; Corporate Officer40
Gerald Conley8729516265IndividualADP of the SNF
Kim Conley0749717106IndividualADP of the SNF
Rex Conley5294262655IndividualADP of the SNF
Sheila W Cook0749268738IndividualADP of the SNF
Iris Lowery6406382969IndividualADP of the SNF
Mcrae Manor Nursing Home Inc0547796104OrganizationADP of the SNF
T Buford Cook Tuw Sr6103352760OrganizationADP of the SNF
Wallace Family Irrevocable Trust9830625417OrganizationADP of the SNF
Billy Wallace4486181849IndividualTrustee of the SNF

Linked facilities

Facility Location % Own. HPRD Ratings Census Flags
Mcrae Manor Nursing Home
Phg Mcrae LLC
92 residents
Other disclo…
3.54Ovr☆☆☆☆Stf★★★☆☆Ins★★☆☆☆QM☆☆☆☆92
  • Phg Mcrae LLC
    Other disclosed role92 res3.54 HPRD
    Overall 1Staffing Staff 3

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
07/01/2024Mcrae Manor Nursing HomePhg Mcrae LLCPine Leaf Investment IncBuyer
  1. 07/01/2024
    Pine Leaf Investment IncPhg Mcrae LLC
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to Phg Mcrae LLC in FEC filings. Similar names may appear—confirm on FEC.gov.