Provider Demographics
NPI:1790908689
Name:EMERITUS PROPERTIES NGH, LLC
Entity Type:Organization
Organization Name:EMERITUS PROPERTIES NGH, LLC
Other - Org Name:BROOKDALE NORTH MESA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LESKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-918-5000
Mailing Address - Street 1:2122 E BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2122 EAST BROWN ROAD
Practice Address - Street 2:
Practice Address - City:MASA
Practice Address - State:AZ
Practice Address - Zip Code:85213-5200
Practice Address - Country:US
Practice Address - Phone:206-298-2909
Practice Address - Fax:206-301-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALC4036310400000X
AZALC-4036310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ700122Medicaid