Shady Rest Care Center, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 4385810233 Enrollment ID O20111227000747

Details

Linked facilitiesFacilities
1
StatesStates
1

13 parties: 4 organizations · 9 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Morgan Lowrimore2365859568IndividualOperational/Managerial Control; ADP of the SNF
Jack H Brown0143381293IndividualOperational/Managerial Control; ADP of the SNF
Bgm Estate LLC6608159512Organization5% or Greater Direct Ownership Interest37.5
Tiffany Seay Exempt Tr3971039264Organization5% or Greater Direct Ownership Interest; ADP of the SNF13.67
Angelus Holdings LLC2668959842Organization5% or Greater Direct Ownership Interest; ADP of the SNF12.5
Philip Marion Green Exempt Tr Cu Gilbert F Green Tr9739554858Organization5% or Greater Direct Ownership Interest; ADP of the SNF11.33
Kelly Mitchell9032190400Individual5% or Greater Indirect Ownership Interest; ADP of the SNF9.38
Angela Tabor9234197146Individual5% or Greater Indirect Ownership Interest; ADP of the SNF9.3
Marcinda Mitchell0143288050Individual5% or Greater Indirect Ownership Interest; ADP of the SNF9.3
Robert Mitchell0749245447Individual5% or Greater Indirect Ownership Interest; ADP of the SNF9.3
Jaci Pitts4385171883IndividualCorporate Officer
Miranda Belt5294262796IndividualCorporate Officer
Sandra Taylor4981879004IndividualCorporate Officer

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Shady Rest Care Center
Shady Rest Care Center, LLC
31 residents
Other disclo…
3.89Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★☆☆☆31
  • Shady Rest Care Center, LLC
    Other disclosed role31 res3.89 HPRD
    Overall 2Staffing Staff 3
Related CMS associates

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