Autumn Woods Residential Health Care Facility LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 8022146653 Enrollment ID O20100527000772

Linked facilitiesFacilities

StatesStates

9 parties: 2 organizations · 7 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Edward Oscar Farbenblum	5395797765	Individual	Corporate Officer; Operational/Managerial Control	95
Vestra SPV3, LLC	6002188158	Organization	5% or Greater Direct Ownership Interest; Operational/Managerial Control	95
Melody A Angel	8729184403	Individual	Contracted Managing Employee	0
Susan Grigg	1456730761	Individual	W-2 Managing Employee	100
Michelle A Miller	9739594383	Individual	5% or Greater Direct Ownership Interest; Corporate Officer	1, 100
Elizabeth J Wolf	1355470550	Individual	5% or Greater Direct Ownership Interest	4
Ralph Rosso	4587017058	Individual	Corporate Officer	100
Tom Phan	4880606607	Individual	Corporate Officer	100
The Mcguire Group	0941118087	Organization	Other	—

Edward Oscar FarbenblumPAC 5395797765
Individual95Corporate Officer; Operational/Managerial Control
Vestra SPV3, LLCPAC 6002188158
Organization955% or Greater Direct Ownership Interest; Operational/Managerial Control
Melody A AngelPAC 8729184403
Individual0Contracted Managing Employee
Susan GriggPAC 1456730761
Individual100W-2 Managing Employee
Michelle A MillerPAC 9739594383
Individual1, 1005% or Greater Direct Ownership Interest; Corporate Officer
Elizabeth J WolfPAC 1355470550
Individual45% or Greater Direct Ownership Interest
Ralph RossoPAC 4587017058
Individual100Corporate Officer
Tom PhanPAC 4880606607
Individual100Corporate Officer
The Mcguire GroupPAC 0941118087
OrganizationOther

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Autumn Woods Residential Health Autumn Woods Residential Health Care Facility LLC 225 residents		Other disclo…	4.00	Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★★☆☆	225

Autumn Woods Residential Health
Autumn Woods Residential Health Care Facility LLC
Other disclosed role225 res4.00 HPRD
Overall 2Staffing Staff 3

Related CMS associates

Name match to Autumn Woods Residential Health Care Facility LLC in FEC filings. Similar names may appear—confirm on FEC.gov.