Villa Camilla LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 7214256528 Enrollment ID O20150508001016

Linked facilitiesFacilities

StatesStates

6 parties: 3 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Caravan Operations Corp	5890913115	Organization	Operational/Managerial Control	100
Eden Jen Kin	3274725171	Individual	Operational/Managerial Control	100
Deutsch 2016 Grat	7214219815	Organization	5% or Greater Direct Ownership Interest	72.23
Rafael Deutsch	1456405653	Individual	5% or Greater Direct Ownership Interest	48.33
Mayer 2012 Trust	7113209537	Organization	5% or Greater Direct Ownership Interest	13.67
Isaac Deutsch	3678855277	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer	72.23, 100

Caravan Operations CorpPAC 5890913115
Organization100Operational/Managerial Control
Eden Jen KinPAC 3274725171
Individual100Operational/Managerial Control
Deutsch 2016 GratPAC 7214219815
Organization72.235% or Greater Direct Ownership Interest
Rafael DeutschPAC 1456405653
Individual48.335% or Greater Direct Ownership Interest
Mayer 2012 TrustPAC 7113209537
Organization13.675% or Greater Direct Ownership Interest
Isaac DeutschPAC 3678855277
Individual72.23, 1005% or Greater Indirect Ownership Interest; Corporate Officer

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Villa Serena Healthcare Center Villa Camilla LLC 48 residents		Other disclo…	4.62	Ovr★★★★★Stf★★★☆☆Ins★★★★☆QM★★★★★	48

Villa Serena Healthcare Center
Villa Camilla LLC
Other disclosed role48 res4.62 HPRD
Overall 5Staffing Staff 3

Related CMS associates

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