Phs Walnut Ridge LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 6800225251 Enrollment ID O20200406001434

Linked facilitiesFacilities

StatesStates

6 parties: 2 organizations · 4 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Phs Management, LLC	5193901049	Organization	Operational/Managerial Control	100
Allison N Bass	9739366956	Individual	W-2 Managing Employee; Operational/Managerial Control	—
Duane W Larson	7810074366	Individual	Corporate Officer; Corporate Director	33
Daniel A Lindh	4183532542	Individual	Corporate Officer; Corporate Director	33
Mark T Meyer	3274441639	Individual	Corporate Officer; Corporate Director	33
Bremer Bank National Association	8628226180	Organization	5% or Greater Mortgage Interest; 5% or Greater Security Interest	74

Phs Management, LLCPAC 5193901049
Organization100Operational/Managerial Control
Allison N BassPAC 9739366956
IndividualW-2 Managing Employee; Operational/Managerial Control
Duane W LarsonPAC 7810074366
Individual33Corporate Officer; Corporate Director
Daniel A LindhPAC 4183532542
Individual33Corporate Officer; Corporate Director
Mark T MeyerPAC 3274441639
Individual33Corporate Officer; Corporate Director
Bremer Bank National AssociationPAC 8628226180
Organization745% or Greater Mortgage Interest; 5% or Greater Security Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Walnut Ridge Phs Walnut Ridge LLC 46 residents		Other disclo…	4.89	Ovr★★★★★Stf★★★★★Ins★★★★☆QM★★★☆☆	46

Walnut Ridge
Phs Walnut Ridge LLC
Other disclosed role46 res4.89 HPRD
Overall 5Staffing Staff 5

Related CMS associates

Name match to Phs Walnut Ridge LLC in FEC filings. Similar names may appear—confirm on FEC.gov.