CCC of Mt. Airy, Inc

Enrollment entity

Provider / enrollment organization Enrollment PAC 6103736327 Enrollment ID O20030612000043

Linked facilitiesFacilities

StatesStates

4 parties: 0 organizations · 4 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Kyle M Payne	0840419651	Individual	Operational/Managerial Control	100
Crystal Epperson	5991965485	Individual	Operational/Managerial Control	—
David Payne	2264692755	Individual	5% or Greater Direct Ownership Interest; Corporate Officer	50
Mark Payne	9537329024	Individual	5% or Greater Direct Ownership Interest; Corporate Officer	50

Kyle M PaynePAC 0840419651
Individual100Operational/Managerial Control
Crystal EppersonPAC 5991965485
IndividualOperational/Managerial Control
David PaynePAC 2264692755
Individual505% or Greater Direct Ownership Interest; Corporate Officer
Mark PaynePAC 9537329024
Individual505% or Greater Direct Ownership Interest; Corporate Officer

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Central Continuing Care CCC of Mt. Airy, Inc 81 residents		Other disclo…	4.36	Ovr★★★☆☆Stf★★★★☆Ins★★★★☆QM★☆☆☆☆	81

Central Continuing Care
CCC of Mt. Airy, Inc
Other disclosed role81 res4.36 HPRD
Overall 3Staffing Staff 4

Related CMS associates

Name match to CCC of Mt. Airy, Inc in FEC filings. Similar names may appear—confirm on FEC.gov.