Village of Lebanon II, LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 9931185980 Enrollment ID O20040629000699

Linked facilitiesFacilities

StatesStates

6 parties: 0 organizations · 6 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Timothy George	9032273933	Individual	5% or Greater Direct Ownership Interest; W-2 Managing Employee	16.67
Farrah Bradshaw Mattingly	4880076751	Individual	W-2 Managing Employee	—
Eva Bland George	3971985847	Individual	5% or Greater Direct Ownership Interest	33.33
David Bryan George	9234041906	Individual	5% or Greater Direct Ownership Interest	16.67
Elmer George	3971599580	Individual	5% or Greater Direct Ownership Interest	16.67
John Cooper	9931263837	Individual	5% or Greater Direct Ownership Interest	16.67

Timothy GeorgePAC 9032273933
Individual16.675% or Greater Direct Ownership Interest; W-2 Managing Employee
Farrah Bradshaw MattinglyPAC 4880076751
IndividualW-2 Managing Employee
Eva Bland GeorgePAC 3971985847
Individual33.335% or Greater Direct Ownership Interest
David Bryan GeorgePAC 9234041906
Individual16.675% or Greater Direct Ownership Interest
Elmer GeorgePAC 3971599580
Individual16.675% or Greater Direct Ownership Interest
John CooperPAC 9931263837
Individual16.675% or Greater Direct Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Village of Lebanon Village of Lebanon II, LLC		Other disclo…	—	Ovr★★☆☆☆Stf—Ins★★★☆☆QM★☆☆☆☆	—

Related CMS associates

Name match to Village of Lebanon II, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.