Healthcare Provider Details

I. General information

NPI: 1245360163
Provider Name (Legal Business Name): EMERITUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 MAIN ST
TEWKSBURY MA
01876-3155
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 978-657-0800
  • Fax: 978-657-8087
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARK OHLENDORF
Title or Position: PRESIDENT/CEO
Credential:
Phone: 414-918-5403