Prairie Manor, Inc

Enrollment entity

Provider / enrollment organization Enrollment PAC 3577690122 Enrollment ID O20100429001149

Linked facilitiesFacilities

StatesStates

9 parties: 1 organizations · 8 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Joseph Mason	4880051606	Individual	Corporate Officer; Operational/Managerial Control; ADP of the SNF	0
Wipfli LLP	4486938859	Organization	Operational/Managerial Control; ADP of the SNF	—
Marianne Peterson	3971960790	Individual	Operational/Managerial Control; ADP of the SNF	—
Roger Manges	8426415241	Individual	Corporate Director	0
William Newman	9335506153	Individual	Corporate Director	0
Julie Peterson	0244697068	Individual	Corporate Director	0
Shadrick Rudlong	1153788971	Individual	Corporate Director	0
Douglas Johnson	2567511959	Individual	Corporate Director	0
Unknown party	3577086594	Individual	ADP of the SNF	—

Joseph MasonPAC 4880051606
Individual0Corporate Officer; Operational/Managerial Control
Wipfli LLPPAC 4486938859
OrganizationOperational/Managerial Control; ADP of the SNF
Marianne PetersonPAC 3971960790
IndividualOperational/Managerial Control; ADP of the SNF
Roger MangesPAC 8426415241
Individual0Corporate Director
William NewmanPAC 9335506153
Individual0Corporate Director
Julie PetersonPAC 0244697068
Individual0Corporate Director
Shadrick RudlongPAC 1153788971
Individual0Corporate Director
Douglas JohnsonPAC 2567511959
Individual0Corporate Director
Unknown partyPAC 3577086594
IndividualADP of the SNF

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Prairie Manor Care Center Prairie Manor, Inc 37 residents		Other disclo…	4.36	Ovr★★★★★Stf★★★★★Ins★★★★☆QM★★★★☆	37

Prairie Manor Care Center
Prairie Manor, Inc
Other disclosed role37 res4.36 HPRD
Overall 5Staffing Staff 5

Related CMS associates

Name match to Prairie Manor, Inc in FEC filings. Similar names may appear—confirm on FEC.gov.