Parmly on the Lake LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 3476811670 Enrollment ID O20171215002600

Linked facilitiesFacilities

StatesStates

11 parties: 6 organizations · 5 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Monarch Healthcare Operating V LLC	0648539726	Organization	Operational/Managerial Control	100
Joshua Legum	6608031091	Individual	Contracted Managing Employee; 5% or Greater Indirect Ownership Interest	28
Spartan Healthcare LLC	2062732324	Organization	5% or Greater Direct Ownership Interest	28
Yazoma Holdings, LLC	6800116161	Organization	5% or Greater Direct Ownership Interest	28
Wbs Holdings LLC	3971861188	Organization	5% or Greater Direct Ownership Interest	19
Jca Holdings LLC	9234497447	Organization	5% or Greater Direct Ownership Interest	15
Nij LLC	7517287873	Organization	5% or Greater Direct Ownership Interest	10
Marc Halpert	4789728924	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer	28
William Stern	4587895701	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer	19
Jeffrey Arem	4789904046	Individual	5% or Greater Indirect Ownership Interest	15
Noam Jaffa	7113158338	Individual	5% or Greater Indirect Ownership Interest; Corporate Director	10

Monarch Healthcare Operating V LLCPAC 0648539726
Organization100Operational/Managerial Control
Joshua LegumPAC 6608031091
Individual28Contracted Managing Employee; 5% or Greater Indirect Ownership Interest
Spartan Healthcare LLCPAC 2062732324
Organization285% or Greater Direct Ownership Interest
Yazoma Holdings, LLCPAC 6800116161
Organization285% or Greater Direct Ownership Interest
Wbs Holdings LLCPAC 3971861188
Organization195% or Greater Direct Ownership Interest
Jca Holdings LLCPAC 9234497447
Organization155% or Greater Direct Ownership Interest
Nij LLCPAC 7517287873
Organization105% or Greater Direct Ownership Interest
Marc HalpertPAC 4789728924
Individual285% or Greater Indirect Ownership Interest; Corporate Officer
William SternPAC 4587895701
Individual195% or Greater Indirect Ownership Interest; Corporate Officer
Jeffrey AremPAC 4789904046
Individual155% or Greater Indirect Ownership Interest
Noam JaffaPAC 7113158338
Individual105% or Greater Indirect Ownership Interest; Corporate Director

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Parmly on the Lake LLC 83 residents		Other disclo…	3.48	Ovr★★★☆☆Stf★★★☆☆Ins★★★☆☆QM★★☆☆☆	83

Parmly on the Lake LLC
Other disclosed role83 res3.48 HPRD
Overall 3Staffing Staff 3

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
12/29/2017	Parmly on the Lake LLC	Parmly on the Lake LLC	Ecumen	Buyer

Related CMS associates

Name match to Parmly on the Lake LLC in FEC filings. Similar names may appear—confirm on FEC.gov.