EDGEWOOD VIRGINIA SENIOR LIVING LLC (NPI# 1518372226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518372226 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD VIRGINIA SENIOR LIVING LLC |
| Practice Address |
605 17th St N Virginia MN 55792-2171 |
| Mailing Address |
322 Demers Ave Suite 500 Grand Forks ND 58201-4754 |
| Practice Telephone | 2187417406 |
| Practice Fax Number | 2187493390 |
| Mailing Telephone | 7017575465 |
| Mailing Fax Number | 7017382001 |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |
| Authorized Official Name | MR. RON WHETTER (VP FINANCE/BUDGET) |
| Authorized Official Telephone | 7017575465 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 363095 | MN | Nursing & Custodial Care Facilities |
| Street Address |
605 17TH ST N |
| City | VIRGINIA |
| State | MN |
| Zip Code | 55792-2171 |
| 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 |
|---|---|---|---|---|
| 1285787481 | Edgewood Vista | Assisted Living Facility | 705 17th St N, Virginia, MN 55792-2176 | 2007-01-19 |
| 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.