EDGEWOOD VISTA (NPI# 1366595597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366595597 |
Entity Type | Organization |
Organization Name | EDGEWOOD VISTA |
Practice Address |
2815 Palmer St Missoula MT 59808-1643 |
Mailing Address |
Po Box 13336 Grand Forks ND 58208-3336 |
Practice Telephone | 4065499660 |
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 | 10029 | MT | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MT | 840191 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245383462 | Edgewood Vista | Assisted Living Facility | 1225 Wicks Ln, Billings, MT 59105-4417 | 2007-01-19 |
1285787481 | Edgewood Vista | Assisted Living Facility | 705 17th St N, Virginia, MN 55792-2176 | 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 |
2815 PALMER ST |
City | MISSOULA |
State | MT |
Zip Code | 59808-1643 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700062957 | Edgewood Missoula Senior Living LLC | Alzheimer Center (Dementia Center) | 2815 Palmer St, Missoula, MT 59808-1643 | 2008-01-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
Find all providers in zip 59808 |
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 |
---|---|---|---|---|
1003318759 | Senescence Care, Inc. | Assisted Living Facility | 3000 St Thomas Dr, Missoula, MT 59803-2946 | 2018-03-07 |
1629475256 | Grandma's House Inc. | Assisted Living Facility | 2327 39th St, Missoula, MT 59803-1124 | 2014-11-25 |
1891057477 | The Heights | Assisted Living Facility | 901 Ben Hogan Dr, Missoula, MT 59803-2402 | 2012-06-11 |
1861677171 | Flor Haven Home LLC | Assisted Living Facility | 433 S 3rd St W, Missoula, MT 59801-2519 | 2008-01-04 |
1790802593 | Gary Alan Wingfield | Assisted Living Facility | 1300 Speedway Ave, Missoula, MT 59802-5566 | 2007-03-25 |
1184749863 | Bonnie Kolden Dba Pleasant View Personal Care Home | Assisted Living Facility | 4322 W Central Ave, Missoula, MT 59804-6216 | 2007-03-20 |
1619015898 | Century Village Inc | Assisted Living Facility | 2120 S Reserve St Pmb 117, Missoula, MT 59801-6451 | 2007-02-01 |
1245268671 | Vsr LLC | Assisted Living Facility | 2815 Old Fort Rd, Missoula, MT 59804-7422 | 2006-06-28 |
1609811306 | Hillside Health Care Center, LLC | Assisted Living Facility | 4718 23rd Ave, Suite 300, Missoula, MT 59803-1163 | 2006-06-17 |
1801454327 | Welltower Tenant Group, LLC | Assisted Living Facility | 3620 American Way, Missoula, MT 59808-1379 | 2019-05-30 |
Find all providers in MISSOULA |
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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.