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General NPI Number Information
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NPI Number | 1952639353
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Entity Type | Organization
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Legal Business Name | EMERITUS CORPORATION
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 2150 W KETTLEMAN LN
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City | LODI
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State | CA
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Zip | 95242-4321
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Country | US
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Telephone | 209-333-8033
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 W KETTLEMAN LN
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City | LODI
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State | CA
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Zip | 95242-4321
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Country | US
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Telephone | 209-333-8033
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | ANNA MUNOZ
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Credential |
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Telephone | 414-918-5443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 397002728
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 397002728
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License Number State | CA
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