Crsca Hc, LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 4284037763 Enrollment ID O20210721001475

Linked facilitiesFacilities

StatesStates

4 parties: 1 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Evangeline B Powell	4082030606	Individual	Corporate Officer; Operational/Managerial Control	100
Rockwell Healthcare LLC	3678976214	Organization	5% or Greater Direct Ownership Interest; Operational/Managerial Control	100
Ricky Cruz Villanueva	6608221957	Individual	W-2 Managing Employee	100
Tanner Peterson	5799150397	Individual	W-2 Managing Employee	100

Evangeline B PowellPAC 4082030606
Individual100Corporate Officer; Operational/Managerial Control
Rockwell Healthcare LLCPAC 3678976214
Organization1005% or Greater Direct Ownership Interest; Operational/Managerial Control
Ricky Cruz VillanuevaPAC 6608221957
Individual100W-2 Managing Employee
Tanner PetersonPAC 5799150397
Individual100W-2 Managing Employee

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Creekside Post Acute Crsca Hc, LLC 52 residents		Other disclo…	6.28	Ovr★★★☆☆Stf★★★☆☆Ins★★★☆☆QM★★☆☆☆	52

Creekside Post Acute
Crsca Hc, LLC
Other disclosed role52 res6.28 HPRD
Overall 3Staffing Staff 3

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
07/01/2021	Creekside Post Acute	Crsca Hc, LLC	Avenue H LLC	Buyer

Related CMS associates

Name match to Crsca Hc, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.