NPIMap

Organization Active NPI

Emeritus Corporation

Doing business as Brookdale River Road

  • Assisted Living Facility
  • Keizer, OR
National Provider Identifier
1184937609
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EMERITUS CORPORATION
Doing business as
Brookdale River Road
Practice address
592 Bever Dr NE
Keizer, OR 97303-4991
Phone
(503) 463-4060
Fax
(503) 304-3090
NPI assigned
Jul 26, 2010
Last updated
Jul 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BROOKDALE SENIOR LIVING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joanne K Leskowicz
Title
Senior Vice President
Phone
(414) 918-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X OR Primary

Addresses

Primary practice location

592 Bever Dr NE
Keizer, OR 97303-4991

Mailing address

6737 W Washington St
Suite 2300
Milwaukee, WI 53214-5647

Other identifiers 1

IdentifierTypeStateIssuer
521966MedicaidOR

Other names 1

  • Brookdale River Road Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2018052Brookdale River Road592 Bever Drive NE, Salem, OR 97303Certificate of waiverJan 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Emeritus Properties-NGH LLC236 organizations share this tax ID, including this one
Part of
Brookdale Senior Living Inc

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1184937609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 BEVER DR NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034991",
            "telephone_number": "503-463-4060",
            "fax_number": "503-304-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2010-07-26",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521966",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale River Road",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookdale River Road",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.