CSL Ce Stephenville, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CSL CE STEPHENVILLE, LLC

Practice address

2010 Good Tree St
Stephenville, TX 76401-6026

Phone

(254) 965-9897

Fax

(254) 918-6003

NPI assigned

Jun 13, 2012

Organization subpart

No

Name

Greg P Boemer

Title

Regional Manager

Phone

(214) 244-2300

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

• Good Tree Retirement Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2012.

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1306108592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 DALLAS PKWY STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752544383",
            "telephone_number": "972-308-8366",
            "fax_number": "972-387-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 GOOD TREE ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764016026",
            "telephone_number": "254-965-9897",
            "fax_number": "254-918-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSL CE STEPHENVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "BOEMER",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "214-244-2300"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Tree Retirement",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Stephenville, TX
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.