CSL 2015 Athens LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

142240 Issued in TX

Legal business name

CSL 2015 ATHENS LLC

Doing business as

Arabella of Athens

Practice address

413 Gibson Rd
Athens, TX 75751-5750

Phone

(903) 675-1995

NPI assigned

Jan 29, 2016

Last updated

Jan 29, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lawrence Wayne Powell Jr.

Title

President

Phone

(817) 386-8888

Specialties & licenses 1

Addresses

Other names 1

• Arabella of Athens Doing business as

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

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1730547241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3973 W VICKERY BLVD",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076492",
            "telephone_number": "817-386-8888",
            "fax_number": "817-386-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 GIBSON RD",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757515750",
            "telephone_number": "903-675-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSL 2015 ATHENS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-386-8888",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "142240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arabella of Athens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Athens, TX
• Providers in Athens, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.