Basic Information
| Provider Information | |||||||||
| NPI: | 1811555733 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMERITOL LO STAUNTON LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 HILLSMERE LN | ||||||||
| Address2: | |||||||||
| City: | STAUNTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244011796 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408859500 | ||||||||
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| Address1: | 1900 HILLSMERE LN | ||||||||
| Address2: | |||||||||
| City: | STAUNTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244011796 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408859500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2019 | ||||||||
| LastUpdateDate: | 06/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | LESKOWICZ | ||||||||
| AuthorizedOfficialFirstName: | JOANNE | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4149185000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BROOKDALE SENIOR LIVING INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.