EDGEWOOD VISTA (NPI# 1790838977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790838977 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD VISTA |
| Practice Address |
608 5th Ave Nw East Grand Forks MN 56721-1738 |
| Mailing Address |
Po Box 13336 Grand Forks ND 58208-3336 |
| Practice Telephone | 2187736648 |
| 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 | 333593 | 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 |
| 1285787481 | Edgewood Vista | Assisted Living Facility | 705 17th St N, Virginia, MN 55792-2176 | 2007-01-19 |
| 1366595597 | Edgewood Vista | Assisted Living Facility | 2815 Palmer St, Missoula, MT 59808-1643 | 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 |
608 5TH AVE NW |
| City | EAST GRAND FORKS |
| State | MN |
| Zip Code | 56721-1738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421316 | Altru Health System | Assisted Living Facility | 605 5th Ave Nw, East Grand Forks, MN 56721 | 2020-06-11 |
| 1770916025 | Erika Marie Severson | Counselor | 1422 Central Ave Nw, East Grand Forks, MN 56721 | 2013-08-09 |
| 1871823021 | Stephanie Hinkle | Physician Assistant | 621 Central Ave Nw, East Grand Forks, MN 56721 | 2010-01-12 |
| 1437355393 | Sanford Clinic North | Family Medicine | 929 Central Avenue, East Grand Forks, MN 56721 | 2007-06-26 |
| 1821290826 | Andrea M Auch | Physical Therapist | 607 Demers Ave - Altru Clinic I East Grand Forks, East Grand Forks, MN 56721 | 2007-06-01 |
| 1891912812 | East Grand Forks Dental Care | Dentist | 22 4th St. Ne, East Grand Forks, MN 56721 | 2007-04-19 |
| 1457423220 | Jeffrey S Haney | Physical Therapist | 607 Demers Ave - Altru Clinic / East Grand Forks, East Grand Forks, MN 56721 | 2006-11-15 |
| 1679514285 | Jon Edwin Bradbury | Family Medicine | 929 Central Ave. Nw, East Grand Forks, MN 56721 | 2006-06-08 |
| 1891215836 | Abbey L Anderson | Nurse Practitioner | 625 Demers Ave, East Grand Forks, MN 56721 | 2017-06-21 |
| 1114314358 | Mridu Gandhi | Family Medicine | 929 Central Ave Nw, East Grand Forks, MN 56721 | 2015-04-24 |
| Find all providers in zip 56721 | ||||
| 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 |
|---|---|---|---|---|
| 1902421316 | Altru Health System | Assisted Living Facility | 605 5th Ave Nw, East Grand Forks, MN 56721 | 2020-06-11 |
| 1831170174 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 2122 River Rd Nw, East Grand Forks, MN 56721-1065 | 2005-11-11 |
| 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 | ||||
| City | EAST GRAND FORKS |
| Zip Code | 56721 |
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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.