MEDICARE: EMERITUS CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311500000X	Alzheimer Center (Dementia Center)	10658	LA
2	310400000X	Assisted Living Facility	10658	LA

General Provider Information

NPI Number	:	1700112570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERITUS CORPORATION

Provider Business Mailing Address
First Line	:	2420 COUNTRY CLUB RD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-8506
Country	:	US
Telephone Number	:	337-478-4030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 COUNTRY CLUB RD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-8506
Country	:	US
Telephone Number	:	337-478-4030
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	ANNA F.C. MUNOZ
Credential	:
Telephone Number	:	414-918-5443

Provider Enumeration Date	:	10/28/2009
Last Update Date	:	03/14/2025

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Directions to “EMERITUS CORPORATION ” Practice Location

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