Twin Maples Health Care Facility

Enrollment entity

Provider / enrollment organization Enrollment PAC 7113835323 Enrollment ID O20111205000652

Linked facilitiesFacilities

StatesStates

8 parties: 0 organizations · 8 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Shelley L Jackson	6103734314	Individual	5% or Greater Direct Ownership Interest; Corporate Officer; Operational/Managerial Control	50
Theodore Jackson	4385552595	Individual	5% or Greater Direct Ownership Interest; Corporate Officer; Operational/Managerial Control	50
John L Caron	5597282269	Individual	Operational/Managerial Control; ADP of the SNF	—
Anuruddha Walaliyadda	9234261298	Individual	Operational/Managerial Control; ADP of the SNF	—
Michele D'amico	1951577386	Individual	Operational/Managerial Control	—
Unknown party	6406373174	Individual	ADP of the SNF	—
Unknown party	7214454982	Individual	ADP of the SNF	—
Unknown party	8123545894	Individual	ADP of the SNF	—

Shelley L JacksonPAC 6103734314
Individual505% or Greater Direct Ownership Interest; Corporate Officer
Theodore JacksonPAC 4385552595
Individual505% or Greater Direct Ownership Interest; Corporate Officer
John L CaronPAC 5597282269
IndividualOperational/Managerial Control; ADP of the SNF
Anuruddha WalaliyaddaPAC 9234261298
IndividualOperational/Managerial Control; ADP of the SNF
Michele D'amicoPAC 1951577386
IndividualOperational/Managerial Control
Unknown partyPAC 6406373174
IndividualADP of the SNF
Unknown partyPAC 7214454982
IndividualADP of the SNF
Unknown partyPAC 8123545894
IndividualADP of the SNF

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Twin Maples Healthcare, Inc Twin Maples Health Care Facility 43 residents		Other disclo…	3.18	Ovr★★★☆☆Stf★★★★☆Ins★★★☆☆QM★★★☆☆	43

Twin Maples Healthcare, Inc
Twin Maples Health Care Facility
Other disclosed role43 res3.18 HPRD
Overall 3Staffing Staff 4

Related CMS associates

Name match to Twin Maples Health Care Facility in FEC filings. Similar names may appear—confirm on FEC.gov.