Provider Demographics
NPI:1336483619
Name:SLH CEDAR PARK, LLC
Entity Type:Organization
Organization Name:SLH CEDAR PARK, LLC
Other - Org Name:SHL CEDAR PARK SNF, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-673-4387
Mailing Address - Street 1:111 E WACKER DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3713
Mailing Address - Country:US
Mailing Address - Phone:312-673-4387
Mailing Address - Fax:312-673-4487
Practice Address - Street 1:2200 S LAKELINE BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4567
Practice Address - Country:US
Practice Address - Phone:512-219-0200
Practice Address - Fax:512-219-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility