CSL - Corvallis, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

1480724513 Issued in OR

Legal business name

CSL - CORVALLIS, LLC

Practice address

400 NW Elks Dr
Corvallis, OR 97330-3744

Phone

(541) 758-8000

NPI assigned

Jun 9, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Will Forsyth

Title

Vice-President, Legal Counsel

Phone

(541) 636-3460

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Regent Court Senior Living Doing business as

Locations

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496966400000",
    "number": "1972032126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 VALLEY RIVER DR STE 260",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012193",
            "telephone_number": "541-636-3460",
            "fax_number": "541-636-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303744",
            "telephone_number": "541-758-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSL - CORVALLIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A",
        "authorized_official_last_name": "FORSYTH",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "VICE-PRESIDENT, LEGAL COUNSEL",
        "authorized_official_telephone_number": "541-636-3460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OR",
            "license": "1480724513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1480724513",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regent Court Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Alan Crumley
• Tashia Monique Crump, EFDA
• Kelley C Crusius, FNP-C
• Veronica Cruzen
• Robert Frank Csintalan, DPT
• Kevin Cuccaro, DO
• Lisa A Cuevas
• Kristi Anne Culley
• Charmagne Marie Cummings, BACHELORS
• Patrick W Cummings

• Alzheimer Center (Dementia Center) in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Alzheimer Center (Dementia Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.