Emeritol Evergreen Lodge LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EMERITOL EVERGREEN LODGE LLC

Doing business as

Brookdale Federal Way

Practice address

31002 14TH Ave S
Federal Way, WA 98003-4712

Phone

(253) 941-0156

NPI assigned

May 30, 2019

Last updated

May 30, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

BROOKDALE SENIOR LIVING INCAs reported in NPPES

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

Addresses

Other names 1

• Brookdale Federal Way Doing business as

Part of

Brookdale Senior Living Inc

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1710545371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31002 14TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034712",
            "telephone_number": "253-941-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31002 14TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034712",
            "telephone_number": "253-941-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITOL EVERGREEN LODGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Federal Way",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clara Jane Elliott, M.S. CCC-SLP
• Haley Grace Elliott
• Mary Beth Elliott, LICSW
• Madeleine C Ellis, PH.D
• Usha R Emani, MD
• Emeritus Corporation (Brookdale Federal Way)
• Mark B Emery, MD
• Rikki Anne Emigh
• Emmanuel House Inc.
• Emmanuel Medical Supply Co

• Assisted Living Facility in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.