King City Rehab, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 3678668183 Enrollment ID O20070928000441

Details

Linked facilitiesFacilities
1
StatesStates
1

50 parties: 21 organizations · 29 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Midcap Finco LLC2961915988Organization5% or Greater Security Interest; Operational/Managerial Control100
Tashina Goettel1951769900IndividualOperational/Managerial Control; ADP of the SNF
Shannon Freeman0547481624IndividualOperational/Managerial Control; ADP of the SNF
Yolanda Presley7113435876IndividualOperational/Managerial Control; ADP of the SNF
Misty Dawn Reid7911314299IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Cody Feakin7810239688IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Tonia Hoskins6709272743IndividualOperational/Managerial Control; Managing Control - Governing Body
Andrew Simpson2769927185IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Mary Kofstad6800962614IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Heatherann Giles1153821483IndividualOperational/Managerial Control; ADP of the SNF
Andrea Doepker8426558750IndividualOperational/Managerial Control; ADP of the SNF
Jolynn Munro7214445972IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Jennifer Dana2264940931IndividualOperational/Managerial Control; ADP of the SNF
David P Larson4688608565IndividualOperational/Managerial Control; ADP of the SNF
Michele Powelson6305354069IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Avamere Health Services LLC3971635988OrganizationOperational/Managerial Control; ADP of the SNF
Avamere Skilled Advisors LLC0244551661OrganizationOperational/Managerial Control; ADP of the SNF
Amanda Sanders8224569199IndividualManaging Control - Governing Body; ADP of the SNF
Glen Robert Cavallo3072421676IndividualManaging Control - Governing Body; ADP of the SNF
Ike Okoli4789025479IndividualManaging Control - Governing Body; ADP of the SNF
Justin Polson5496056632IndividualManaging Control - Governing Body; ADP of the SNF
Carrie Vanderzanden9830607597IndividualManaging Control - Governing Body; ADP of the SNF
Michelle Funderberg1153839816IndividualManaging Control - Governing Body; ADP of the SNF
Nancy Adams0244748903IndividualManaging Control - Governing Body; ADP of the SNF
Colby Strunk5395253058IndividualManaging Control - Governing Body; ADP of the SNF
Show all 50 parties (25 more)
NameOwner/control PACTypeRole(s)%
Midcap Finco LLC2961915988Organization5% or Greater Security Interest; Operational/Managerial Control100
Tashina Goettel1951769900IndividualOperational/Managerial Control; ADP of the SNF
Shannon Freeman0547481624IndividualOperational/Managerial Control; ADP of the SNF
Yolanda Presley7113435876IndividualOperational/Managerial Control; ADP of the SNF
Misty Dawn Reid7911314299IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Cody Feakin7810239688IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Tonia Hoskins6709272743IndividualOperational/Managerial Control; Managing Control - Governing Body
Andrew Simpson2769927185IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Mary Kofstad6800962614IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Heatherann Giles1153821483IndividualOperational/Managerial Control; ADP of the SNF
Andrea Doepker8426558750IndividualOperational/Managerial Control; ADP of the SNF
Jolynn Munro7214445972IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Jennifer Dana2264940931IndividualOperational/Managerial Control; ADP of the SNF
David P Larson4688608565IndividualOperational/Managerial Control; ADP of the SNF
Michele Powelson6305354069IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Avamere Health Services LLC3971635988OrganizationOperational/Managerial Control; ADP of the SNF
Avamere Skilled Advisors LLC0244551661OrganizationOperational/Managerial Control; ADP of the SNF
Amanda Sanders8224569199IndividualManaging Control - Governing Body; ADP of the SNF
Glen Robert Cavallo3072421676IndividualManaging Control - Governing Body; ADP of the SNF
Ike Okoli4789025479IndividualManaging Control - Governing Body; ADP of the SNF
Justin Polson5496056632IndividualManaging Control - Governing Body; ADP of the SNF
Carrie Vanderzanden9830607597IndividualManaging Control - Governing Body; ADP of the SNF
Michelle Funderberg1153839816IndividualManaging Control - Governing Body; ADP of the SNF
Nancy Adams0244748903IndividualManaging Control - Governing Body; ADP of the SNF
Colby Strunk5395253058IndividualManaging Control - Governing Body; ADP of the SNF
Kevin Hill8325556087IndividualManaging Control - Governing Body; ADP of the SNF
Todd Inskeep4789192444IndividualManaging Control - Governing Body; ADP of the SNF
Ariso LLC3072616960OrganizationDirect Ownership Interest100
Ari Operations, LLC2163694282OrganizationIndirect Ownership Interest100
Avamere Group LLC6507865482OrganizationIndirect Ownership Interest100
Karl Rickard Miller1355250598IndividualIndirect Ownership Interest100
Unknown party0143720466OrganizationADP of the SNF
Unknown party1153821475OrganizationADP of the SNF
Unknown party4981104205OrganizationADP of the SNF
Unknown party7416457734OrganizationADP of the SNF
Unknown party8426558743OrganizationADP of the SNF
Unknown party9234639550OrganizationADP of the SNF
Unknown party0345740668OrganizationADP of the SNF
Unknown party1254831571OrganizationADP of the SNF
Unknown party1355841677OrganizationADP of the SNF
Unknown party3072013390OrganizationADP of the SNF
Unknown party4183124407OrganizationADP of the SNF
Kim Games6103326442IndividualADP of the SNF
Julie Davis6709386030IndividualADP of the SNF
Carolyn Staples3476053711IndividualADP of the SNF
Brett Hereford5294235537IndividualADP of the SNF
Unknown party1456851773OrganizationADP of the SNF
Unknown party3274033592OrganizationADP of the SNF
Unknown party6002316320OrganizationADP of the SNF
Unknown party8729588041OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Avamere Rehabilitation of King City
King City Rehab, LLC
65 residents
Other disclo…
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Related CMS associates

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Name match to King City Rehab, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.