NPI 1396005195

Emeritus Corporation

Organisation Assisted Living Facility Prescott, AZ

Practice location

Address: 211 Bradshaw Dr, Prescott, AZ 86303-4405
Phone: (928) 777-5511
Fax: (928) 777-2155
Mailing address: 3131 Elliott Ave Suite 500, Seattle, WA 98121-1044

Authorised official

Name: Tracy Allen
Title: Director Medicaid Services
Phone: (214) 701-7249

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence AL8058C (AZ)

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Registry record

NPI: 1396005195
Entity type: Organization
NPI issued: 25 May 2012
Record last updated: 25 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.