NPIMap

Organization Active NPI

Emeritus Corporation

Doing business as Brookdale Grants Pass Village

  • Assisted Living Facility
  • Grants Pass, OR
National Provider Identifier
1750695987
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EMERITUS CORPORATION
Doing business as
Brookdale Grants Pass Village
Practice address
1420 Redwood Cir
Grants Pass, OR 97527-5536
Phone
(541) 474-0200
Fax
(541) 472-8478
NPI assigned
Jul 29, 2010
Last updated
Feb 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Mark Ohlendorf
Title
President/Ceo
Phone
(414) 918-5403

Specialties & licenses 1

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

Addresses

Primary practice location

1420 Redwood Cir
Grants Pass, OR 97527-5536

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
521954MedicaidOR

Other names 1

  • Brookdale Grants Pass Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Emeritus Properties-NGH LLC236 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1750695987",
    "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": "1420 REDWOOD CIR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275536",
            "telephone_number": "541-474-0200",
            "fax_number": "541-472-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "OHLENDORF",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "414-918-5403"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521954",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Grants Pass Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.