Provider Demographics
NPI:1356690747
Name:CSL CE CORPUS, LLC
Entity type:Organization
Organization Name:CSL CE CORPUS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-237-2496
Mailing Address - Street 1:5813 ESPLANADE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4113
Mailing Address - Country:US
Mailing Address - Phone:361-991-9600
Mailing Address - Fax:361-980-8989
Practice Address - Street 1:5813 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4113
Practice Address - Country:US
Practice Address - Phone:361-991-9600
Practice Address - Fax:361-980-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility