Provider Demographics
NPI:1003298399
Name:CSL-LAS CRUCES LLC
Entity Type:Organization
Organization Name:CSL-LAS CRUCES LLC
Other - Org Name:DESERT PEAKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSYTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-636-3460
Mailing Address - Street 1:1600 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2138
Mailing Address - Country:US
Mailing Address - Phone:541-636-3460
Mailing Address - Fax:
Practice Address - Street 1:5525 COTTON BLOOM CT
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-5822
Practice Address - Country:US
Practice Address - Phone:575-523-0300
Practice Address - Fax:575-523-8687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CSL-NEW MEXICO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2266310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility