Bear Mt Mattapan LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 6406190347 Enrollment ID O20181204003199

Linked facilitiesFacilities

StatesStates

4 parties: 1 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Thomas H Doyle	7618299058	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer; W-2 Managing Employee	33.33
Bear Mountain Healthcare LLC	7517232572	Organization	5% or Greater Direct Ownership Interest	100
John B Wynne	6709108145	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer	33.33
Scott L Ziskin	1951482215	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer	33.33

Thomas H DoylePAC 7618299058
Individual33.335% or Greater Indirect Ownership Interest; Corporate Officer
Bear Mountain Healthcare LLCPAC 7517232572
Organization1005% or Greater Direct Ownership Interest
John B WynnePAC 6709108145
Individual33.335% or Greater Indirect Ownership Interest; Corporate Officer
Scott L ZiskinPAC 1951482215
Individual33.335% or Greater Indirect Ownership Interest; Corporate Officer

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Care Village at Mattapan Bear Mt Mattapan LLC 74 residents		Other disclo…	2.85	Ovr★★☆☆☆Stf★★☆☆☆Ins★★☆☆☆QM★★★★☆	74

Care Village at Mattapan
Bear Mt Mattapan LLC
Other disclosed role74 res2.85 HPRD
Overall 2Staffing Staff 2

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
12/01/2018	Care Village at Mattapan	Bear Mt Mattapan LLC	Vero Health II LLC	Buyer

12/01/2018
Care Village at Mattapan (Buyer)
Vero Health II LLC → Bear Mt Mattapan LLC

Related CMS associates

Name match to Bear Mt Mattapan LLC in FEC filings. Similar names may appear—confirm on FEC.gov.