MEDICARE: S-H OPCO PRESTON, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1427465442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S-H OPCO PRESTON, LLC

Provider Business Mailing Address
First Line	:	6737 W WASHINGTON ST
Second Line	:	SUITE 2300
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-5647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12400 PRESTON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1866
Country	:	US
Telephone Number	:	972-661-3111
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MARK OHLENDORF
Credential	:
Telephone Number	:	414-918-5000

Provider Enumeration Date	:	07/22/2014
Last Update Date	:	07/22/2014

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