Watermanidence Opco LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 6103137849 Enrollment ID O20150622001288

Details

Linked facilitiesFacilities
1
StatesStates
1

10 parties: 3 organizations · 7 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Nicoletta Jenkins4284945932IndividualW-2 Managing Employee; Operational/Managerial Control
Sepehr Golboo7719259084IndividualContracted Managing Employee
Providence Group Nh, LLC5294198396Organization5% or Greater Direct Ownership Interest100
Pacs Group, Inc.7911360011Organization5% or Greater Indirect Ownership Interest100
Pacs Holdings, LLC6103289202Organization5% or Greater Indirect Ownership Interest100
Jason H Murray0648228304Individual5% or Greater Indirect Ownership Interest41.8
Mark D Hancock9830337005Individual5% or Greater Indirect Ownership Interest; Corporate Officer41.8
Frederick G Apt4486043916IndividualCorporate Officer
John T Mitchell0648429498IndividualCorporate Officer
Joshua O Jergensen6800024092IndividualCorporate Officer

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Waterman Canyon Post Acute
Watermanidence Opco LLC
154 residents
Other disclo…
4.01Ovr★★★★Stf★★☆☆☆Ins★★★★QM★★★★154
  • Watermanidence Opco LLC
    Other disclosed role154 res4.01 HPRD
    Overall 4Staffing Staff 2
Related CMS associates

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Name match to Watermanidence Opco LLC in FEC filings. Similar names may appear—confirm on FEC.gov.