Organization · Type 2 NPI

Emeritus Corporation

Assisted Living Facility · Chubbuck, ID

NPI number 1275675498 Active

Practice location

4080 Hawthorne Road
Chubbuck, ID 83202

Call (208) 237-3000 Map

Fax (208) 237-6024

Mailing address

6737 W Washington St Ste 2300
Milwaukee, WI 53214-5650

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	RC-772 (ID)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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NPI record

NPI: 1275675498
Entity type: Organization (Type 2)
Issued: Feb 13, 2007
Last updated: Jul 20, 2020
Status: Active
Subpart: Yes of Brookdale Senior Living Inc

Other names

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Brookdale Chubbuck · doing business as
Brookdale Chubbuck · doing business as

Authorized official

Joanne K Leskowicz
Senior Vice President
(414) 918-5000

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1275675498

Emeritus Corporation's National Provider Identifier is 1275675498, issued on Feb 13, 2007. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Chubbuck, ID. The record was last updated on Jul 20, 2020.