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	311500000X	Alzheimer Center (Dementia Center)	0132	CT
2	310400000X	Assisted Living Facility	0132	CT

General Provider Information

NPI Number	:	1992033674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERITUS CORPORATION

Provider Business Mailing Address
First Line	:	3131 ELLIOTT AVE
Second Line	:	SUITE 500
City	:	SEATTLE
State	:	WA
Zip	:	98121-1044
Country	:	US
Telephone Number	:	206-298-2909
Fax Number	:	206-301-4500

Provider Business Practice Location Address
First Line	:	330 AMITY RD
Second Line	:
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-2131
Country	:	US
Telephone Number	:	203-389-2911
Fax Number	:	203-389-2916

Authorized Official
Title or Position	:	LICENSING SPECIALIST
Name	:	NOELLE DIAZ BICKEL
Credential	:
Telephone Number	:	206-298-2909

Provider Enumeration Date	:	11/18/2009
Last Update Date	:	11/18/2009

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Directions to “EMERITUS CORPORATION ” Practice Location

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