Organization
CSL HAMPTONS 2016, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE WAYNE POWELL JR. (PRESIDENT)
(817) 386-8888
Entity
Organization
Contact information
Practice address
4250 OLD OMEN RD, TYLER, TX 75707-2161
(903) 566-0460
Mailing address
4250 OLD OMEN RD, TYLER, TX 75707-2161
(903) 566-0460
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
139406
TX
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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