Queen ANN'S Lace Holdings, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 7810174802 Enrollment ID O20110531000078

Details

Linked facilitiesFacilities
1
StatesStates
1

11 parties: 4 organizations · 7 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Shivani Bhutani9436344355IndividualContracted Managing Employee
Abraham Olson3072051531IndividualW-2 Managing Employee
Capital SNF Holding Company, LLC4789039553Organization5% or Greater Direct Ownership Interest100
Pacs Group, Inc.7911360011Organization5% or Greater Indirect Ownership Interest100
Pacs Holdings, LLC6103289202Organization5% or Greater Indirect Ownership Interest100
Providence Group Nh, LLC5294198396Organization5% or Greater Indirect Ownership Interest100
Mark D Hancock9830337005Individual5% or Greater Indirect Ownership Interest; Corporate Officer41.8
Jason H Murray0648228304Individual5% or Greater Indirect Ownership Interest41.8
Frederick G Apt4486043916IndividualCorporate Officer
John T Mitchell0648429498IndividualCorporate Officer
Joshua O Jergensen6800024092IndividualCorporate Officer

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Whitney Oaks Care Center
Queen ANN'S Lace Holdings, LLC
120 residents
Other disclo…
3.96Ovr★★★☆☆Stf★★★☆☆Ins★★☆☆☆QM★★★★★120
  • Queen ANN'S Lace Holdings, LLC
    Other disclosed role120 res3.96 HPRD
    Overall 3Staffing Staff 3
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