Organization
EMERITUS CORPORATION
Active
Other names
Brookdale Champlin
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER)
(615) 564-8131
Entity
Organization
Contact information
Practice address
119 HAYDEN LAKE RD E, CHAMPLIN, MN 55316-1547
(763) 712-0118
(763) 712-0278
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
368149
—
MN
05
—
369591
—
MN
Enumeration date
07/28/2010
Last updated
05/16/2016
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