NPIMap

Organization Active NPI

Emeritus Corporation

Doing business as Emeritus at Olive Grove

  • Assisted Living Facility
  • Phoenix, AZ
National Provider Identifier
1902028145
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
ALC-P-4752 Issued in AZ
Legal business name
EMERITUS CORPORATION
Doing business as
Emeritus at Olive Grove
Practice address
3014 E Indian School Rd
Phoenix, AZ 85016-6887
Phone
(602) 957-7021
Fax
(602) 957-0830
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Noelle Diaz Bickel
Title
Licensing Specialist
Phone
(206) 298-2909

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X
Assisted Living Facility 310400000X ALC-P-4752 AZ Primary
Alzheimer Center (Dementia Center) 311500000X

Addresses

Primary practice location

3014 E Indian School Rd
Phoenix, AZ 85016-6887

Mailing address

3131 Elliott Ave
Suite 500
Seattle, WA 98121-1044
Phone (206) 298-2909

Other identifiers 1

IdentifierTypeStateIssuer
ALC-4752MedicaidAZ

Other names 1

  • Emeritus at Olive Grove Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Emeritus Properties Ark Willow Brook LLC236 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 11

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1902028145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211044",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166887",
            "telephone_number": "602-957-7021",
            "fax_number": "602-957-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "DIAZ",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC-P-4752",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ALC-4752",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emeritus at Olive Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.