Provider Demographics
NPI:1922016641
Name:COLUMBUS REGIONAL SENIOR LIVING INC
Entity type:Organization
Organization Name:COLUMBUS REGIONAL SENIOR LIVING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CRSL CEO ANDCHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-660-6102
Mailing Address - Street 1:100 SPRING HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-4619
Mailing Address - Country:US
Mailing Address - Phone:706-576-6000
Mailing Address - Fax:706-576-6065
Practice Address - Street 1:100 SPRING HARBOR DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4619
Practice Address - Country:US
Practice Address - Phone:706-576-6000
Practice Address - Fax:706-576-6064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-106-1839314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
115716Medicare Oscar/Certification