Lakebridge, a Waters Community, LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 9133400161 Enrollment ID O20170104002426

Linked facilitiesFacilities

StatesStates

3 parties: 1 organizations · 2 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Wesley Garland	6103281647	Individual	W-2 Managing Employee	0
Gubin Enterprises Limited Partnership	0345542114	Organization	5% or Greater Direct Ownership Interest	50
Michael Blisko	3577476589	Individual	5% or Greater Direct Ownership Interest	50

Wesley GarlandPAC 6103281647
Individual0W-2 Managing Employee
Gubin Enterprises Limited PartnershipPAC 0345542114
Organization505% or Greater Direct Ownership Interest
Michael BliskoPAC 3577476589
Individual505% or Greater Direct Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Lakebridge, a Waters Community, LLC 105 residents		Other disclo…	3.26	Ovr★★★☆☆Stf★☆☆☆☆Ins★★★★☆QM★★★★☆	105

Lakebridge, a Waters Community, LLC
Other disclosed role105 res3.26 HPRD
Overall 3Staffing Staff 1

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
08/01/2016	Lakebridge, a Waters Community, LLC	Lakebridge, a Waters Community, LLC	Lakebridge Medical Investors, LLC	Buyer

08/01/2016
Lakebridge, a Waters Community, LLC (Buyer)
Lakebridge Medical Investors, LLC → Lakebridge, a Waters Community, LLC

Related CMS associates

Name match to Lakebridge, a Waters Community, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.