Healthcare Provider Details

I. General information

NPI: 1700901501
Provider Name (Legal Business Name): EMERITUS PROPERTIES NGH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5861 W BEVERLY LN
GLENDALE AZ
85306-1804
US

IV. Provider business mailing address

5861 W BEVERLY LN
GLENDALE AZ
85306-1804
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-7166
  • Fax: 602-938-7164
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberALC-4038
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALC-4038
License Number StateAZ

VIII. Authorized Official

Name: JOANNE LESKOWICZ
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 414-918-5000