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EMERITUS CORPORATION NPI 1932437332


NPI Information

NPI: 1932437332
Provider Name: EMERITUS CORPORATION

Doing Business As: BROOKDALE NORTHDALE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 10D0961539

Address:
3401 W BEARSS AVE
TAMPA, FL
ZIP 33618
Phone: (813) 961-1044
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EMERITUS CORPORATION is an assisted living facility in Tampa, FL. The provider is 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. EMERITUS CORPORATION NPI is 1932437332. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale Northdale.

The provider's business location address is:

3401 W BEARSS AVE
TAMPA, FL
ZIP 33618-143
Phone: (813) 961-1044

The provider's authorized official is Bryan Richardson .
The authorized official title is Evp, Chief Admin. Officer and has the following contact phone number (615) 564-8131.

The CLIA number assigned to this NPI record is 10D0961539 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2009 and was last updated on 5/13/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityAL9500FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10121245-00MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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