Williamsville Suburban, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 8123913092 Enrollment ID O20040219000090

Details

Linked facilitiesFacilities
1
StatesStates
1

3 parties: 0 organizations · 3 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
David Goldman0648603688IndividualCorporate Director; Operational/Managerial Control0
Laura Z Otterbein5698674893Individual5% or Greater Direct Ownership Interest45.5
William H Zacher3870492077Individual5% or Greater Direct Ownership Interest45.5

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Williamsville Suburban, L L C
Williamsville Suburban, LLC
208 residents
Other disclo…
3.30Ovr☆☆☆☆Stf★★☆☆☆Ins☆☆☆☆QM★★☆☆☆208
  • Williamsville Suburban, LLC
    Other disclosed role208 res3.30 HPRD
    Overall 1Staffing Staff 2
Related CMS associates

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