EDGEWOOD VISTA


Address: 705 17th St N, Virginia, MN 55792-2176
Phone: 2187417106

EDGEWOOD VISTA (NPI# 1285787481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility 334105 MN Nursing & Custodial Care Facilities

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations EDGEWOOD VISTA, LLC 21708 Se 245th St, Maple Valley, WA 98038

Office Location

Street Address 705 17TH ST N
City VIRGINIA
State MN
Zip Code 55792-2176

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy 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.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City VIRGINIA
Zip Code 55792

Improve Information

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Dataset Information

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.

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