EDGEWOOD VISTA (NPI# 1285787481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285787481 |
Entity Type | Organization |
Organization Name | EDGEWOOD VISTA |
Practice Address |
705 17th St N Virginia MN 55792-2176 |
Mailing Address |
Po Box 13336 Grand Forks ND 58208-3336 |
Practice Telephone | 2187417106 |
Mailing Fax Number | 7017382001 |
Enumeration Date | 2007-01-19 |
Last Update Date | 2020-08-22 |
Authorized Official Name | BRETT WILKENING (BILLING) |
Authorized Official Telephone | 7017382000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | 334105 | MN | Nursing & Custodial Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245383462 | Edgewood Vista | Assisted Living Facility | 1225 Wicks Ln, Billings, MT 59105-4417 | 2007-01-19 |
1366595597 | Edgewood Vista | Assisted Living Facility | 2815 Palmer St, Missoula, MT 59808-1643 | 2007-01-19 |
1790838977 | Edgewood Vista | Assisted Living Facility | 608 5th Ave Nw, East Grand Forks, MN 56721-1738 | 2007-01-19 |
1720131931 | Edgewood Vista | Assisted Living Facility | 1011 Cardinal Dr, Belgrade, MT 59714-8373 | 2007-01-19 |
1407909633 | Edgewood Vista | Assisted Living Facility | 141 Interstate Ln, Kalispell, MT 59901-2877 | 2007-01-19 |
1356494520 | Edgewood Vista | Assisted Living Facility | 14890 Beaver Dam Rd, Brainerd, MN 56401-6019 | 2007-01-19 |
1982757175 | Edgewood Vista | Assisted Living Facility | 4195 Westberg Rd, Hermantown, MN 55811-3916 | 2007-01-19 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | EDGEWOOD VISTA, LLC | 21708 Se 245th St, Maple Valley, WA 98038 |
Street Address |
705 17TH ST N |
City | VIRGINIA |
State | MN |
Zip Code | 55792-2176 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629610506 | Brandi Lynn Kilbourn | Occupational Therapist | 705 17th St N, Virginia, MN 55792-2176 | 2019-10-12 |
1740637578 | Jordyn Renee Drees | Occupational Therapist | 705 17th St N, Virginia, MN 55792 | 2016-05-23 |
1699094540 | David Chester Tollefson | Occupational Therapist | 705 17th St N, Virginia, MN 55792 | 2010-05-18 |
1508185463 | Chad Alan Baribeau | Physical Therapist | 705 17th St N, Virginia, MN 55792-2176 | 2010-05-18 |
1962667964 | Elizabeth Ann Paczynski | Physical Therapist | 705 17th St N, Virginia, MN 55792 | 2008-07-20 |
1508040395 | Edgewood Virginia I Senior Living LLC | Assisted Living Facility | 705 17th St N, Virginia, MN 55792-2176 | 2007-12-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598252983 | Teresa A Larrabee | Social Worker | 624 South 13th Street, Virginia, MN 55792 | 2018-04-20 |
1972874105 | Caryn M. Walters | Counselor | 504 1st St. S., Virginia, MN 55792 | 2012-01-19 |
1144502923 | Crystal Corrine Leal | Student in an Organized Health Care Education/Training Program | 624 S. 13th St., Virginia, MN 55792 | 2011-09-16 |
1417259110 | Ellen C. Taube | Pharmacist | 306 Chestnut, Virginia, MN 55792 | 2010-12-01 |
1518295567 | Virginia-gilbert Family Dental P.a | Dentist | 612-13th. St. So., Virginia, MN 55792 | 2009-12-03 |
1942442082 | Arrowhead Economic Opportunity Agency | In Home Supportive Care | 702 South Third Avenue, Virginia, MN 55792 | 2009-04-06 |
1609037324 | Stefan Leroy Kaiser | Preventive Medicine | 1101 9th St. N, Essentia Health Virginia Clinic, Virginia, MN 55792 | 2008-06-25 |
1457512915 | Duane Faccin Person | Legal Medicine | 910 6th St N, Duluth Clinic Virginia, Virginia, MN 55792 | 2008-06-18 |
1932368313 | Range Mental Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 731 3rd St S, Virginia, MN 55792 | 2008-06-02 |
1871634071 | Gary Frederick Miller | Social Worker | 624 S 13th Street, P O 1188, Virginia, MN 55792 | 2007-02-09 |
Find all providers in zip 55792 |
Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
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. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518372226 | Edgewood Virginia Senior Living LLC | Assisted Living Facility | 605 17th St N, Virginia, MN 55792-2171 | 2014-06-23 |
1508040395 | Edgewood Virginia I Senior Living LLC | Assisted Living Facility | 705 17th St N, Virginia, MN 55792-2176 | 2007-12-28 |
1023236767 | Lakeview Residence | Assisted Living Facility | 201 N 6th Ave, Virginia, MN 55792-2437 | 2007-04-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871193417 | Midwest Group Home | Assisted Living Facility | 4232 5th St Ne, Columbia Heights, MN 55421-2860 | 2020-10-30 |
1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
1750980603 | Estherra Care LLC | Assisted Living Facility | 1120 Morgan Ave N, Minneapolis, MN 55411-3805 | 2020-10-21 |
1679189682 | Daniel Care Homes LLC | Assisted Living Facility | 6809 Perry Ave N, Brooklyn Center, MN 55429-1611 | 2020-09-16 |
1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
1811509870 | Aurora Assisted Living LLC | Assisted Living Facility | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
1003427477 | In My Father's House | Assisted Living Facility | 3096 Snelling Ave N, Roseville, MN 55113-1659 | 2020-08-11 |
1710595863 | Eden Prairie Senior Living | Assisted Living Facility | 8480 Franlo Rd, Eden Prairie, MN 55344-2938 | 2020-07-15 |
1447868468 | Brightstar Services LLC | Assisted Living Facility | 1821 University Ave W Ste 120, Saint Paul, MN 55104-2811 | 2020-07-15 |
1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.