EDGEWOOD FARGO SENIOR LIVING LLC (NPI# 1588826390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588826390 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD FARGO SENIOR LIVING LLC |
| Practice Address |
4420 37th Ave S Fargo ND 58104-3400 |
| Mailing Address |
2850 24th Ave S Suite 201 Grand Forks ND 58201-5831 |
| Practice Telephone | 7013658200 |
| Practice Fax Number | 7013658200 |
| Mailing Telephone | 7017382000 |
| Mailing Fax Number | 7017382001 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |
| Authorized Official Name | GENE HYSJULIEN (CEO) |
| Authorized Official Telephone | 7017382000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | 8103A | ND | Nursing & Custodial Care Facilities |
| Street Address |
4420 37TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619148467 | Edgewood Fargo Senior Living, LLC | Assisted Living Facility | 4420 37th Ave S, Fargo, ND 58104-3400 | 2008-03-20 |
| 1437634706 | Caringedge Hospice of Fargo | Hospice Care, Community Based | 4420 37th Ave S, Fargo, ND 58104-3400 | 2018-10-02 |
| 1194200469 | Caringedge Healthcare of Fargo | Home Health | 4420 37th Ave S, Fargo, ND 58104-3400 | 2018-10-02 |
| 1629557624 | Laura Beth Marquardt | Physical Therapist | 4420 37th Ave S, Fargo, ND 58104-3400 | 2018-08-09 |
| 1265819528 | Cindy Zink | Occupational Therapist | 4420 37th Ave S, Therapy Room, Fargo, ND 58104-3400 | 2015-05-06 |
| 1366843641 | Sarah Coplin | Physical Therapist | 4420 37th Ave S, Fargo, ND 58104-3400 | 2014-09-05 |
| 1598173288 | Matthew Huber | Physical Therapist | 4420 37th Ave S, Fargo, ND 58104-3400 | 2014-07-26 |
| 1548540826 | Sanford Medical Center Fargo | Internal Medicine | 4420 37th Ave S, Fargo, ND 58104-3400 | 2011-08-18 |
| 1255623187 | Sanford Clinic North | Clinic/Center | 4420 37th Ave S, Fargo, ND 58104-3400 | 2011-05-11 |
| 1003076613 | Professional Rehabilitation Center Inc | Physical Therapist | 4420 37th Ave S, Fargo, ND 58104-3400 | 2008-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605310 | Fargo Maple View LLC | Alzheimer Center (Dementia Center) | 4552 36th Ave S, Fargo, ND 58104-5211 | 2020-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908345 | Minot Gv LLC | Alzheimer Center (Dementia Center) | 2805 Elk Dr, Minot, ND 58701-5605 | 2020-10-08 |
| 1750988143 | Maple View II East Inc | Alzheimer Center (Dementia Center) | 4217 Montreal St, Bismarck, ND 58503-0325 | 2020-10-08 |
| 1740887132 | Grand View LLC | Alzheimer Center (Dementia Center) | 4650 S Washington St, Grand Forks, ND 58201-7222 | 2020-10-08 |
| 1548426430 | Shipley Basic Care | Alzheimer Center (Dementia Center) | 1505 3 St Se, Jamestown, ND 58401 | 2008-07-31 |
| 1740452374 | Edgewood Vista Senior Living, Inc | Alzheimer Center (Dementia Center) | 715 17th Ave Se, Minot, ND 58701-6753 | 2008-03-24 |
| 1083794432 | Aneta Nursing Home Incorporated | Alzheimer Center (Dementia Center) | 113 5th St S, Box 287, Aneta, ND 58212-4226 | 2006-10-17 |
| 1659543288 | Edgewood Bismarck Senior Living, LLC | Alzheimer Center (Dementia Center) | 3406 Dominion St, Bismarck, ND 58503-5577 | 2008-03-24 |
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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.