170 West Avenue Operating Company LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 8729354931 Enrollment ID O20171016001528

Details

Linked facilitiesFacilities
1
StatesStates
1

4 parties: 1 organizations · 3 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Jeffrey Rubin7315854270Individual5% or Greater Indirect Ownership Interest; Corporate Officer; Operational/Managerial Control50
Warren D Cole7517874233Individual5% or Greater Indirect Ownership Interest; Corporate Officer; Operational/Managerial Control50
Philip Quillard3375450059IndividualOperational/Managerial Control
170 West Avenue Operating Holdco LLC6901172113Organization5% or Greater Direct Ownership Interest100

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Elderwood of Lakeside at Brockport
170 West Avenue Operating Company LLC
105 residents
Other disclo…
2.69Ovr★★★★Stf☆☆☆☆Ins★★★★QM★★★★★105

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
01/01/2018Elderwood of Lakeside at Brockport170 West Avenue Operating Company LLCLakeside Beikirch Care Center IncBuyer
  1. 01/01/2018
    Lakeside Beikirch Care Center Inc170 West Avenue Operating Company LLC
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to 170 West Avenue Operating Company LLC in FEC filings. Similar names may appear—confirm on FEC.gov.