Healthcare Provider Details

I. General information

NPI: 1255542072
Provider Name (Legal Business Name): EMERITUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 KELLOGG AVE
CORONA CA
92879-3111
US

IV. Provider business mailing address

2005 KELLOGG AVE
CORONA CA
92879-3111
US

V. Phone/Fax

Practice location:
  • Phone: 951-898-6991
  • Fax:
Mailing address:
  • Phone: 951-898-6991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number336409202
License Number StateCA

VIII. Authorized Official

Name: ANNA MUNOZ
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 414-918-5443