Emeritus Corporation
Organization Active NPI Assisted Living Facility · Champlin, MN
NPI 1992019244 · NPPES record last updated May 16, 2016
Key facts
- NPI
- 1992019244
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- EMERITUS CORPORATION
- Practice address
- 119 Hayden Lake Rd E
Champlin, MN 55316-1547 - Phone
- (763) 712-0118
- Fax
- (763) 712-0278
- NPI assigned
- Jul 28, 2010
- Organization subpart
- No
Authorized official
- Name
- Bryan Richardson
- Title
- Evp, Chief Admin. Officer
- Phone
- (615) 564-8131
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Emeritus Properties NGH LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | MN | Yes |
Addresses
Primary practice location
119 Hayden Lake Rd E
Champlin, MN 55316-1547
Mailing address
6737 W Washington St
Suite 2300
Milwaukee, WI 53214-5647
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 368149 | Medicaid | MN | |
| 369591 | Medicaid | MN |
Other names
- Brookdale Champlin
Other providers in Champlin, MN
- Arielle Dudundane
- Ajibola Jelilat Edwards
- David Andrew Ehlert
- Annalyssa Marie Eigenheer
- Lea Hilda Ekochin
- Christopher David Emery
- Erin Erickson
- Heidi Estrem
- Maurice Chimezie Etete
- Christina A Evensen
All providers in Champlin, MN · Assisted Living Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.