Provider Demographics
NPI:1215212550
Name:CSL LAURELHURST NC, LLC
Entity Type:Organization
Organization Name:CSL LAURELHURST NC, LLC
Other - Org Name:LAURELWOODS ASSISTED LIVING
Other - Org Type:Other Name
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-255-5407
Mailing Address - Street 1:550 S MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2539
Mailing Address - Country:US
Mailing Address - Phone:864-255-5407
Mailing Address - Fax:864-239-5887
Practice Address - Street 1:1062 W MILLS ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-8635
Practice Address - Country:US
Practice Address - Phone:828-894-3900
Practice Address - Fax:828-894-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility