Organization
EMERITUS CORPORATION
Active
Other names
The Peridot Assisted Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ALLEN (DIRECTOR MEDICAID SERVICES)
(214) 701-7249
Entity
Organization
Contact information
Practice address
211 BRADSHAW DR, PRESCOTT, AZ 86303-4405
(928) 777-5511
(928) 777-2155
Mailing address
3131 ELLIOTT AVE, SUITE 500, SEATTLE, WA 98121-1044
(206) 298-2909
(206) 357-7292
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8058C
AZ
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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