MEDICARE: EMERITUS CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL7866C	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	016944	OTHER	AZ	AZ AHCCCS

General Provider Information

NPI Number	:	1194056622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERITUS CORPORATION

Provider Business Mailing Address
First Line	:	2650 W INA RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-4210
Country	:	US
Telephone Number	:	520-229-0232
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 W INA RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-4210
Country	:	US
Telephone Number	:	520-229-0232
Fax Number	:	520-229-0259

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	JOANNE K LESKOWICZ
Credential	:
Telephone Number	:	414-918-5000

Provider Enumeration Date	:	01/22/2010
Last Update Date	:	07/16/2020

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Directions to “EMERITUS CORPORATION ” Practice Location

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