Mansfield Long Term Care, LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 9931412178 Enrollment ID O20150717000617

Details

Linked facilitiesFacilities
1
StatesStates
1

8 parties: 5 organizations · 3 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Thi of Texas LLC6901890128Organization5% or Greater Direct Ownership Interest; Operational/Managerial Control100
Ryan K Leblanc5092949081IndividualCorporate Officer; Operational/Managerial Control; ADP of the SNF
Hunt Valley Holdings LLC9234149113Organization5% or Greater Indirect Ownership Interest100
Thi of Baltimore, Inc.9234049222Organization5% or Greater Indirect Ownership Interest100
Murray Forman4789622614Individual5% or Greater Indirect Ownership Interest100
Camelia M Rigsby2062561558IndividualADP of the SNF
Fundamental Administrative Services LLC8325297716OrganizationADP of the SNF
Fundamental Clinical and Operational Services, LLC3375717549OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
The Pavilion at Creekwood
Mansfield Long Term Care, LLC
97 residents
Other disclo…
3.21Ovr★★☆☆☆Stf★★☆☆☆Ins★★☆☆☆QM★★★★97
  • Mansfield Long Term Care, LLC
    Other disclosed role97 res3.21 HPRD
    Overall 2Staffing Staff 2
Related CMS associates

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