Organization
EMERITUS CORPORATION
Active
Other names
La Villa
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ALLEN (DIRECTOR MEDICAID SERVICES)
(206) 298-2909
Entity
Organization
Contact information
Practice address
300 E JOHN CARPENTER FWY, SUITE LL112, IRVING, TX 75062-2727
(972) 893-2616
Mailing address
2725 N PENNSYLVANIA AVE, ROSWELL, NM 88201-0617
(575) 625-8426
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
NM
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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