EMERITUS CORPORATION NPI 1952639353

NPI Information

  • NPI: 1952639353
  • Provider Name: EMERITUS CORPORATION
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: BROOKDALE KETTLEMAN LANE
  • CLIA Number: 05D2292541
  • Address: 2150 W KETTLEMAN LN
    LODI, CA
    ZIP 95242
  • Phone: (209) 333-8033

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NPI Details

EMERITUS CORPORATION is an assisted living facility in Lodi, CA. 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 1952639353. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale Kettleman Lane.

The provider's business location address is:

2150 W KETTLEMAN LN
LODI, CA
ZIP 95242-321
Phone: (209) 333-8033

The provider's authorized official is Anna Munoz .
The authorized official title is Assistant Secretary and has the following contact phone number (414) 918-5443.

The CLIA number assigned to this NPI record is 05D2292541 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2009 and was last updated on 8/2/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility397002728CALIFORNIAYes
2311500000XAlzheimer Center (Dementia Center)397002728CALIFORNIANo

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: 3/30/2025

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