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BROOKDALE CHUBBUCK
NPI 1275675498
Assisted Living Facility in Chubbuck, ID

Active since February 13, 2007CLIA 13D2196433 · Waiver
4080 HAWTHORNE ROAD, CHUBBUCK, ID 83202(208) 237-3000(208) 237-6024 Get Directions Write a Review

NPPES record last updated: July 20, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 20, 2020, Jun 13, 2016 (2 updates tracked since 2016).

About Brookdale Chubbuck NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKDALE CHUBBUCK (NPI 1275675498) is a healthcare organization registered as an assisted living facility in Chubbuck, Idaho and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through September 17, 2027 and lists Joanne K Leskowicz, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1275675498
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEMERITUS CORPORATION
Location Address4080 HAWTHORNE ROADChubbuck, ID 83202
Mailing Address6737 W Washington St Ste 2300Milwaukee, WI 53214-5650 · (414) 918-5000 · Fax (206) 357-7292
Phone(208) 237-3000
Fax(208) 237-6024
Organization SubpartYesParent: Brookdale Senior Living Inc
Authorized OfficialJoanne K LeskowiczSenior Vice President · (414) 918-5000
Enumeration DateFebruary 13, 2007
Last NPPES UpdateJuly 20, 20202 updates tracked since enumeration
NPPES CertifiedJuly 20, 2020
✔ NPI 1275675498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in ID · RC-772
Definition
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.
4080 HAWTHORNE ROAD, Chubbuck, ID 83202
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Other Names 1

Doing Business AsBrookdale Chubbuck

Other Identifiers 2

MedicaidM8054377ID
Medicaid805437700ID

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2196433

Brookdale Chubbuck · Chubbuck, ID
Active · expires Sep 17, 2027
CLIA Number13D2196433
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 18, 2025
Certificate Expiration DateSeptember 17, 2027
Laboratory DirectorMitchell L. Wach
Laboratory Phone(208) 648-4565
Laboratory LocationBrookdale Chubbuck4080 Hawthorne Rd, Chubbuck, ID 83202
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emeritus Corporation's NPI number?

The NPI number for Emeritus Corporation is 1275675498. It was assigned to this organization in the NPPES registry on February 13, 2007. The provider is doing business as Brookdale Chubbuck.

Where is Emeritus Corporation located?

Emeritus Corporation is located at 4080 Hawthorne Road, Chubbuck, ID 83202. The listed phone number is (208) 237-3000.

What is Emeritus Corporation's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Emeritus Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2196433) is associated with this NPI, valid through September 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Emeritus Corporation was last updated on July 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.