COFFMAN-LEVI Charitable Trust, Inc

Enrollment entity

Provider / enrollment organization Enrollment PAC 6305986308 Enrollment ID O20091223000400

Linked facilitiesFacilities

StatesStates

6 parties: 0 organizations · 6 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Jeffrey Fritzen	7214077031	Individual	Corporate Director; W-2 Managing Employee	100
Wes A Siefkes	2365763885	Individual	Corporate Officer	20
Henry Gramann	1658411657	Individual	Corporate Officer	20
Ronald Sutter	5193865194	Individual	Corporate Officer	20
Susan Hershberger	7012057011	Individual	Corporate Officer	—
Henry Gramann	0749320745	Individual	Corporate Director	—

Jeffrey FritzenPAC 7214077031
Individual100Corporate Director; W-2 Managing Employee
Wes A SiefkesPAC 2365763885
Individual20Corporate Officer
Henry GramannPAC 1658411657
Individual20Corporate Officer
Ronald SutterPAC 5193865194
Individual20Corporate Officer
Susan HershbergerPAC 7012057011
IndividualCorporate Officer
Henry GramannPAC 0749320745
IndividualCorporate Director

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Gold Crest Retirement Center COFFMAN-LEVI Charitable Trust, Inc 36 residents		Other disclo…	0.64	Ovr★★★☆☆Stf★☆☆☆☆Ins★★★★☆QM★★★★☆	36

Gold Crest Retirement Center
COFFMAN-LEVI Charitable Trust, Inc
Other disclosed role36 res0.64 HPRD
Overall 3Staffing Staff 1

Related CMS associates

Name match to COFFMAN-LEVI Charitable Trust, Inc in FEC filings. Similar names may appear—confirm on FEC.gov.