Healthcare Provider Details

I. General information

NPI: 1851696934
Provider Name (Legal Business Name): EMERITUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S 63RD ST
MESA AZ
85206-6016
US

IV. Provider business mailing address

6737 W WASHINGTON ST SUITE 2300
MILWAUKEE WI
53214-5647
US

V. Phone/Fax

Practice location:
  • Phone: 480-985-5778
  • Fax: 480-854-4610
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRYAN RICHARDSON
Title or Position: EVP, CHIEF ADMIN. OFFICER
Credential:
Phone: 615-564-8131