Provider Demographics
NPI:1457725137
Name:SL YORK, LLC
Entity Type:Organization
Organization Name:SL YORK, LLC
Other - Org Name:MAHONEY HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDRED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-362-5538
Mailing Address - Street 1:1810 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-2241
Mailing Address - Country:US
Mailing Address - Phone:402-362-5538
Mailing Address - Fax:402-362-5680
Practice Address - Street 1:1810 E 12TH ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-2241
Practice Address - Country:US
Practice Address - Phone:402-362-5538
Practice Address - Fax:402-362-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF105310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility