EDGEWOOD RAPID CITY LLC (NPI# 1972076024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972076024 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD RAPID CITY LLC |
| Practice Address |
4001 Derby Lane Rapid City SD 57701 |
| Mailing Address |
322 Demers Ave Ste 500 Grand Forks ND 58201 |
| Practice Telephone | 6057183600 |
| Practice Fax Number | 7017382001 |
| Mailing Telephone | 7017575410 |
| Mailing Fax Number | 7017382001 |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-14 |
| Authorized Official Name | JOHN DYBWAD (VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 7017575422 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
4001 DERBY LANE |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528623345 | Julie Maas | Counselor | 625 1/2 Main St, Suite 1, Rapid City, SD 57701 | 2019-05-07 |
| 1902300247 | Theresa Gibbens | Speech-Language Pathologist | 3301 Grandview Drive, Rapid City, SD 57701 | 2018-03-21 |
| 1407355423 | Arielle Leigh Loveridge | Chiropractor | 610 East Boulevard, Suite 1, Rapid City, SD 57701 | 2018-02-05 |
| 1083125082 | Sarah Kirschman | Nurse Practitioner | 353 Fairmont Boulvevard, Rapid City, SD 57701 | 2017-10-17 |
| 1992225239 | Kelsey Elizabeth Wondercheck | Dentist | 717 Meade Street, Suite 200, Rapid City, SD 57701 | 2017-06-27 |
| 1316476088 | Rhianna Wickett | Physical Therapist | 420 E Saint Patrick St Ste 101, Rapid City, SD 57701 | 2017-06-07 |
| 1841727773 | Cynthia A Gates | Dietitian, Registered | 2908 5th Street, Rapid City, SD 57701 | 2017-05-23 |
| 1811447758 | Alyssa Marquardt | Psychologist | 433 Mt. Rushmore Road, Rapid City, SD 57701 | 2016-10-04 |
| 1578913232 | .indian Health Service | Clinic/Center | 241 East Meade St, Rapid City, SD 57701 | 2016-06-14 |
| 1295114700 | Ron J Scherr | Counselor | 1520 N. Haines Ave, Suite 6, Rapid City, SD 57701 | 2015-05-29 |
| Find all providers in zip 57701 | ||||
| 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 |
|---|---|---|---|---|
| 1760835052 | Rclalc,llc | Assisted Living Facility | 409 E Fairlane Dr, Rapid City, SD 57701-7207 | 2016-07-21 |
| 1740438670 | Good Samaritan Society-echo Ridge | Assisted Living Facility | 931 Fox Run Dr, Rapid City, SD 57701-2386 | 2008-09-04 |
| 1811180565 | Paradise Pines LLC | Assisted Living Facility | 4110 Winfield Street, Rapid City, SD 57701 | 2007-08-24 |
| 1174715023 | Theres A Hart Inc. | Assisted Living Facility | 2303 Michigan Ave, Rapid City, SD 57701-5655 | 2007-08-14 |
| 1629277223 | The Victorian Assisted Living Home | Assisted Living Facility | 1321 Columbus St, Rapid City, SD 57701-2524 | 2007-07-13 |
| 1982817045 | Presbyterian Retirement Village of Rapid City, Inc. | Assisted Living Facility | 133 Texas St, Rapid City, SD 57701 | 2007-05-07 |
| 1043422918 | Regional Health Network Inc | Assisted Living Facility | 409 E Fairlane Drive, Rapid City, SD 57701 | 2007-05-04 |
| 1336287911 | Pinehaven, Inc | Assisted Living Facility | 23776 Pine Haven Dr, Rapid City, SD 57702-7407 | 2007-02-03 |
| 1811469687 | Rapid City Assisted Living, LLC | Assisted Living Facility | 2000 Wesleyan Blvd, Rapid City, SD 57702-9340 | 2018-12-18 |
| 1245724509 | Esl Sd Victorian Operations LLC | Assisted Living Facility | 1321 Columbus St, Rapid City, SD 57701-2505 | 2018-06-20 |
| Find all providers in RAPID CITY | ||||
| City | RAPID CITY |
| Zip Code | 57701 |
Please comment or provide details below to improve the information on EDGEWOOD RAPID CITY 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.