Organization
EMERITUS CORPORATION
Active
Other names
Brookdale Kettleman Lane
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA MUNOZ (ASSISTANT SECRETARY)
(414) 918-5443
Entity
Organization
Contact information
Practice address
2150 W KETTLEMAN LN, LODI, CA 95242-4321
(209) 333-8033
Mailing address
2150 W KETTLEMAN LN, LODI, CA 95242-4321
(209) 333-8033
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
397002728
CA
311500000X
Alzheimer Center (Dementia Center)
397002728
CA
Other
Enumeration date
11/23/2009
Last updated
08/02/2024
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