SL Wahoo, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALF152 Issued in NE

Legal business name

SL WAHOO, LLC

Practice address

1313 N Hackberry St
Wahoo, NE 68066-1148

Phone

(402) 443-3333

Fax

(402) 443-5578

NPI assigned

Nov 18, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Damien Simmons

Title

Executive Director

Phone

(402) 443-3333

Specialties & licenses 1

Addresses

Other names 1

• Saunders House Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1992179675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 N HACKBERRY ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680661148",
            "telephone_number": "402-443-3333",
            "fax_number": "402-443-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 N HACKBERRY ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680661148",
            "telephone_number": "402-443-3333",
            "fax_number": "402-443-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SL WAHOO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DAMIEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-443-3333"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saunders House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah Danielle Schauer-Emerson, DPT
• Linda Schulzkump, M.D.
• Gretchen Michelle Seagren
• Kelsey Sestak
• Sophie Raye Sherman
• Patricia Sloup
• Heath Kenneth Smith
• Michael J Spicka, DPT
• Mary Rosemarie Stapert, PTA
• Rebecca Lynn Stuck

• Assisted Living Facility in Wahoo, NE
• Providers in Wahoo, NE by specialty
• Assisted Living Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.