Revive Sparks LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 7113301458 Enrollment ID O20220906000343

Details

Linked facilitiesFacilities
1
StatesStates
1

11 parties: 4 organizations · 7 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Zachary S Gray6507069044Individual5% or Greater Indirect Ownership Interest; 5% or Greater Mortgage Interest; Corporate Officer99, 48.51, 100
Chelsey Gray4789922030IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF1
Irtqa Ilyas6406108505IndividualOperational/Managerial Control; ADP of the SNF
Kaitlyn Modina5698285690IndividualOperational/Managerial Control; ADP of the SNF
Joseph Nasrawy2860492147IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Marie Nadora2062609696IndividualOperational/Managerial Control; Managing Control - Governing Body; ADP of the SNF
Revive Health Senior Care Management LLC9234477589OrganizationOperational/Managerial Control; ADP of the SNF
Gray Estate Holdings LLC9931583275Organization5% or Greater Direct Ownership Interest; 5% or Greater Mortgage Interest; ADP of the SNF100, 49
Wingfield Hills Rd. LLC8527578525Organization5% or Greater Mortgage Interest; ADP of the SNF100
Asl Realty LLC5395264840Organization5% or Greater Mortgage Interest; ADP of the SNF49
Andrew Lebowitz6709048002Individual5% or Greater Mortgage Interest48.51

Linked facilities

Facility Location % Own. HPRD Ratings Census Flags
Other disclo…
3.02Ovr★★☆☆☆Stf★★★★Ins★★☆☆☆QM★★★☆☆116

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
02/01/2022Wingfield Skilled Nursing and Rehabilitation CenteRevive Sparks LLCWingfield Health Care LLCBuyer
  1. 02/01/2022
    Wingfield Health Care LLCRevive Sparks LLC
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to Revive Sparks LLC in FEC filings. Similar names may appear—confirm on FEC.gov.