Wailea Beach, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 8527577659 Enrollment ID O20250602000622

Details

Linked facilitiesFacilities
1
StatesStates
1

7 parties: 1 organizations · 6 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Daniel Deangelo4385153337IndividualOperational/Managerial Control; ADP of the SNF
Kalesta Healthcare Group, LLC7810240488Organization5% or Greater Direct Ownership Interest100
Ryan Williams6002043015Individual5% or Greater Indirect Ownership Interest; Corporate Officer; ADP of the SNF44.05
Scott Clawson0648409938Individual5% or Greater Indirect Ownership Interest; Corporate Officer; ADP of the SNF44.05
Micah Porter1658750799Individual5% or Greater Indirect Ownership Interest7
Scott Clawson4385644368Individual5% or Greater Indirect Ownership Interest4.9
Mary Hickcox5496264343IndividualADP of the SNF

Linked facilities

Facility Location % Own. HPRD Ratings Census Flags
Sequim Bay Post Acute
Wailea Beach, LLC
88 residents
Other disclo…
3.73Ovr★★★★Stf★★★☆☆Ins★★★☆☆QM★★★★★88
  • Wailea Beach, LLC
    Other disclosed role88 res3.73 HPRD
    Overall 4Staffing Staff 3
Related CMS associates

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