The Waters of Springfield, LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 7416235668 Enrollment ID O20161024000970

Linked facilitiesFacilities

StatesStates

4 parties: 2 organizations · 2 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Benton Welsh	5395766356	Individual	W-2 Managing Employee	0
Gubin Enterprises Limited Partnership	0345542114	Organization	5% or Greater Direct Ownership Interest	40
Michael Blisko	3577476589	Individual	5% or Greater Direct Ownership Interest	40
A&F Realty LLC	1951334226	Organization	5% or Greater Direct Ownership Interest	20

Benton WelshPAC 5395766356
Individual0W-2 Managing Employee
Gubin Enterprises Limited PartnershipPAC 0345542114
Organization405% or Greater Direct Ownership Interest
Michael BliskoPAC 3577476589
Individual405% or Greater Direct Ownership Interest
A&F Realty LLCPAC 1951334226
Organization205% or Greater Direct Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
The Waters of Springfield LLC The Waters of Springfield, LLC 46 residents		Other disclo…	2.90	Ovr★☆☆☆☆Stf★☆☆☆☆Ins★☆☆☆☆QM★★★★☆	46

The Waters of Springfield LLC
The Waters of Springfield, LLC
Other disclosed role46 res2.90 HPRD
Overall 1Staffing Staff 1

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
08/01/2016	The Waters of Springfield LLC	The Waters of Springfield, LLC	Christian Care Center of Springfield LLC	Buyer

08/01/2016
The Waters of Springfield LLC (Buyer)
Christian Care Center of Springfield LLC → The Waters of Springfield, LLC

Related CMS associates

Name match to The Waters of Springfield, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.