Provider Demographics
NPI:1023239704
Name:EMERITUS CORPORATION
Entity type:Organization
Organization Name:EMERITUS CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:BICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-298-2909
Mailing Address - Street 1:3131 ELLIOTT AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1044
Mailing Address - Country:US
Mailing Address - Phone:206-298-2909
Mailing Address - Fax:206-301-4500
Practice Address - Street 1:1991 SAUL KLEINFELD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-3757
Practice Address - Country:US
Practice Address - Phone:915-857-5487
Practice Address - Fax:915-857-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101344311500000X
TX120254310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001003388Medicaid