N & R of Anderson LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 6901186444 Enrollment ID O20161129002116

Linked facilitiesFacilities

StatesStates

4 parties: 1 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Timothy O Drake	3971775743	Individual	Operational/Managerial Control	100
Ltc Management Services LLC	6901967710	Organization	Operational/Managerial Control	100
James C Lincoln	7315856572	Individual	5% or Greater Direct Ownership Interest	50
Judy L Lincoln	9537141445	Individual	5% or Greater Direct Ownership Interest	50

Timothy O DrakePAC 3971775743
Individual100Operational/Managerial Control
Ltc Management Services LLCPAC 6901967710
Organization100Operational/Managerial Control
James C LincolnPAC 7315856572
Individual505% or Greater Direct Ownership Interest
Judy L LincolnPAC 9537141445
Individual505% or Greater Direct Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Mcdonald County Living Center N & R of Anderson LLC 58 residents		Other disclo…	3.15	Ovr★★★★☆Stf★★★☆☆Ins★★★★☆QM★★★★☆	58

Mcdonald County Living Center
N & R of Anderson LLC
Other disclosed role58 res3.15 HPRD
Overall 4Staffing Staff 3

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
09/01/2016	Mcdonald County Living Center	N & R of Anderson LLC	Ggnsc Anderson LLC	Buyer

09/01/2016
Mcdonald County Living Center (Buyer)
Ggnsc Anderson LLC → N & R of Anderson LLC

Related CMS associates

Name match to N & R of Anderson LLC in FEC filings. Similar names may appear—confirm on FEC.gov.