Basic Information
Provider Information
NPI: 1033422530
EntityType: 2
ReplacementNPI:  
OrganizationName: EMERITUS CORPORATION
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BROOKDALE RIO RANCHO
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6737 W WASHINGTON ST
Address2: SUITE2300
City: MILWAUKEE
State: WI
PostalCode: 532145647
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1000 RIVERVIEW DR SE
Address2:  
City: RIO RANCHO
State: NM
PostalCode: 871240920
CountryCode: US
TelephoneNumber: 5058928400
FaxNumber: 5058961655
Other Information
ProviderEnumerationDate: 07/26/2010
LastUpdateDate: 05/16/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RICHARDSON
AuthorizedOfficialFirstName: BRYAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EVP, CHIEF ADMIN. OFFICER
AuthorizedOfficialTelephone: 6155648131
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
310400000X NMY Nursing & Custodial Care FacilitiesAssisted Living Facility 

No ID Information.


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