Provider Demographics
NPI:1114560869
Name:CSL - LEBANON, LLC
Entity Type:Organization
Organization Name:CSL - LEBANON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
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 1:360 E 10TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3273
Mailing Address - Country:US
Mailing Address - Phone:541-636-3460
Mailing Address - Fax:541-636-3797
Practice Address - Street 1:181 S 5TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2745
Practice Address - Country:US
Practice Address - Phone:541-258-7706
Practice Address - Fax:541-258-2233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASS SENIOR LIVING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility