Healthcare Provider Details
I. General information
NPI: 1407184062
Provider Name (Legal Business Name): EMERITUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
220 CONANT ST
DANVERS MA
01923-2586
US
IV. Provider business mailing address
3131 ELLIOTT AVE SUITE 500
SEATTLE WA
98121-1044
US
V. Phone/Fax
- Phone: 978-777-5717
- Fax: 978-777-1283
- Phone: 206-298-2909
- Fax: 206-301-4500
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 311500000X |
| Taxonomy | Alzheimer Center (Dementia Center) |
| License Number | |
| License Number State | MA |
VIII. Authorized Official
Name:
NOELLE
DIAZ
BICKEL
Title or Position: LICENSING SPECIALIST
Credential:
Phone: 206-298-2909