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NPI Code Detail

MEDICARE: CSL ELKHORN, LLC

MEDICARE: CSL ELKHORN, 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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1639517295
Entity Type Code : Organization
Provider Name (Legal Business Name) : CSL ELKHORN, LLC
Provider Business Mailing Address
First Line : 20800 W MAPLE RD
Second Line :
City : ELKHORN
State : NE
Zip : 68022-5108
Country : US
Telephone Number : 402-289-9229
Fax Number :
Provider Business Practice Location Address
First Line : 20800 W MAPLE RD
Second Line :
City : ELKHORN
State : NE
Zip : 68022-5108
Country : US
Telephone Number : 402-289-9229
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SUMMER SARGENT
Credential :
Telephone Number : 402-289-9229
Provider Enumeration Date : 06/05/2013
Last Update Date : 08/18/2016

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Directions to “CSL ELKHORN, LLC ” Practice Location

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