EDGEWOOD SPEARFISH SENIOR LIVING LLC (NPI# 1942486584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942486584 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD SPEARFISH SENIOR LIVING LLC |
| Practice Address |
540 Falcon Crest Dr Spearfish SD 57783-3255 |
| Mailing Address |
2850 24th Ave S Suite 201 Grand Forks ND 58201-5831 |
| Practice Telephone | 7017382000 |
| Practice Fax Number | 7017382001 |
| Mailing Telephone | 7017382000 |
| Mailing Fax Number | 7017382001 |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |
| 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 | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
49736 | SD | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922284033 | Edgewood Spearfish Senior Living LLC | Assisted Living Facility | 540 Falcon Crest Dr, Spearfish, SD 57783-3255 | 2008-01-18 |
| Street Address |
540 FALCON CREST DR |
| City | SPEARFISH |
| State | SD |
| Zip Code | 57783-3255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548313992 | Edgewood Vista Senior Living Inc | Assisted Living Facility | 540 Falcon Crest Dr, Spearfish, SD 57783-3255 | 2007-01-19 |
| 1417425448 | Megan Marie Strain | Occupational Therapist | 540 Falcon Crest Dr, Spearfish, SD 57783-3252 | 2018-11-07 |
| 1184109464 | Caringedge Healthcare of Spearfish | Home Health | 540 Falcon Crest Dr, Spearfish, SD 57783-3252 | 2018-10-02 |
| 1992280275 | Caringedge Hospice of Spearfish | Hospice Care, Community Based | 540 Falcon Crest Dr, Spearfish, SD 57783-3252 | 2018-10-02 |
| 1851569347 | Heidi Marie Williams I | Occupational Therapy Assistant | 540 Falcon Crest Dr, Spearfish, SD 57783-3252 | 2008-02-18 |
| 1922284033 | Edgewood Spearfish Senior Living LLC | Assisted Living Facility | 540 Falcon Crest Dr, Spearfish, SD 57783-3255 | 2008-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386091338 | Acupuncture of The Black Hills, LLC | Acupuncturist | 144 N. Main St., Spearfish, SD 57783 | 2016-05-19 |
| 1568695013 | Krew Enterprises, Inc Bda Comfort Keepers, 490 | Home Health | 119 East Grant Street, Ste 1, Spearfish, SD 57783 | 2009-09-01 |
| 1518193093 | Lorri A. Riley, Dpm PC | Podiatrist | 1410 North Ave #1, Spearfish, SD 57783 | 2009-06-10 |
| 1104065317 | Heather Rae Glasford | Speech-Language Pathologist | 1107 Charles Street, Spearfish, SD 57783 | 2009-02-11 |
| 1861605230 | Justin Bruce Johnson | Chiropractor | 4029 E. Colorado Blvd, Spearfish, SD 57783 | 2007-05-08 |
| 1467670976 | Karin Wood | Counselor | 146 W. Illinois St., Ste A, Spearfish, SD 57783 | 2007-04-22 |
| 1205999315 | Black Hills Counseling Services | Counselor | 146 W Illinois Street, Suite A, Spearfish, SD 57783 | 2006-12-19 |
| 1154489920 | Brooke Melody Hvachovec Thompson | Occupational Therapist | Spearfish Regional Hospital, 1440 N Main Street, Spearfish, SD 57783 | 2006-12-05 |
| 1780758060 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 428 E Colorado Blvd, Spearfish, SD 57783 | 2006-11-20 |
| 1063584423 | Regional Health Physicians Inc | Durable Medical Equipment & Medical Supplies | 1420 N. 10th Street, Spearfish, SD 57783 | 2006-11-14 |
| Find all providers in zip 57783 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
Please comment or provide details below to improve the information on EDGEWOOD SPEARFISH SENIOR LIVING LLC.
| 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.